Liew Gerald, Moore Anthony T, Webster Andrew R, Michaelides Michel
Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, Australia Moorfields Eye Hospital, London, United Kingdom.
Moorfields Eye Hospital, London, United Kingdom University College London, Institute of Ophthalmology, London, United Kingdom.
Invest Ophthalmol Vis Sci. 2015 Feb 10;56(3):1531-6. doi: 10.1167/iovs.14-15995.
To determine the efficacy and prognostic factors associated with carbonic anhydrase inhibitors (CAI) in the treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP).
This was a cohort study of 81 subjects who were assessed before and after treatment. Spectral-domain optical coherence tomography (SD-OCT) was used to quantify CME. A reduction of at least 11% in central subfield (CSF) thickness was defined as objective evidence of response.
In the 125 eyes that received topical dorzolamide, 40.0% demonstrated a response to treatment with a mean reduction in OCT CSF thickness of 105 μm (95% confidence interval [CI]: 82, 128). Mean starting visual acuity (VA) increased from 6/15 to 6/12 after a median time on treatment of 3.0 months. In patients prescribed oral acetazolamide, 28.1% of eyes (41.2% of patients) showed improvement in mean OCT CSF thickness of 115 μm (95% CI: 52, 177) over a median treatment interval of 4.0 months. Visual acuity improved from 6/15 to 6/12. Eyes that responded to topical dorzolamide were more likely to have autosomal recessive than autosomal dominant RP (44.6% vs. 23.3%, P = 0.02), and a higher mean baseline OCT CSF than eyes that did not respond (P = 0.02).
We report that 40.0% of eyes (53.1% of patients) showed an objective improvement in CME after treatment with topical dorzolamide and 28.1% of eyes (41.2% of patients) after treatment with oral acetazolamide. Autosomal recessive RP and greater initial central retinal thickness predicted response to treatment with topical dorzolamide.
确定碳酸酐酶抑制剂（CAI）治疗视网膜色素变性（RP）患者黄斑囊样水肿（CME）的疗效及预后因素。
这是一项对81名受试者治疗前后进行评估的队列研究。采用光谱域光学相干断层扫描（SD - OCT）对CME进行量化。中心子野（CSF）厚度至少降低11%被定义为治疗有反应的客观证据。
在接受局部用多佐胺治疗的125只眼中，40.0%的眼对治疗有反应，OCT测量的CSF厚度平均降低105μm（95%置信区间[CI]：82，128）。治疗中位时间3.0个月后平均初始视力（VA）从6/15提高到6/12。在服用口服乙酰唑胺的患者中，28.1%的眼（41.2%的患者）在中位治疗间隔4.0个月期间OCT测量的CSF厚度平均改善115μm（95%CI：52，177）。视力从6/15提高到6/12。对局部用多佐胺有反应的眼比常染色体显性RP的眼更可能是常染色体隐性RP（44.6%对23.3%，P = 0.02），且平均基线OCT CSF厚度高于无反应的眼（P = 0.02）。
我们报告，局部用多佐胺治疗后40.0%的眼（53.1%的患者）CME有客观改善，口服乙酰唑胺治疗后28.1% 的眼（41.2%的患者）有改善。常染色体隐性RP及更大的初始中心视网膜厚度预示对局部用多佐胺治疗有反应。
