Efficacy of additional topical betamethasone in persistent cystoid macular oedema after carbonic anhydrase inhibitor treatments in retinitis pigmentosa

ObjectiveWe investigated the efficacy of additional topical betamethasone in persistent cystoid macular oedema (CMO) after carbonic anhydrase inhibitors (CAIs) therapy.Methods and analysisThis retrospective cohort study included 16 eyes of 10 patients with retinitis pigmentosa (RP). All patients were previously administered CAI for at least 3 months to treat CMO secondary to RP and lacking an effective reduction (≥11%) of central foveal thickness (CFT). We administered topical 0.1% betamethasone daily in each affected eye following a preceding course of the CAI medication as a first treatment. CMO was diagnosed using spectral-domain optical coherence tomography. CFT was regarded as the average of vertical and horizontal foveal thickness. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained from patient medical records. We compared the CFT and BCVA between baseline and the average of 1–3, 5–7, 10–14 and 16–20 months period.ResultsIn treatments with brinzolamide in 14 eyes, dorzolamide in 2 eyes and bromfenac in 2 eyes, CFT effectively decreased in 12 of 16 eyes (81%). CFT decreased significantly in 1–3 months (326±102 µm; n=16; P=0.029) and 5–7 months (297±102 µm; n=12; P=0.022) compared with baseline but not within 10–14 months (271±96 µm; n=9; P=0.485) or 16–20 months (281±134 µm; n=9; P=0.289). There were no significant intergroup differences in BCVA throughout the study. Betamethasone treatment was stopped in three patients because of IOP elevation.ConclusionOur data suggested that additional betamethasone might improve treatments for persistent CMO. Topical steroids could be an alternative option for managing persistent CMO in RP.

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Outcomes of three intravitreal injections of bevacizumab given monthly for diabetic macular oedema is a viable treatment for an economically disadvantaged population

African Vision and Eye Health ◽

10.4102/aveh.v80i1.618 ◽

2021 ◽

Vol 80 (1) ◽

Author(s):

Aazambir S. Brar ◽

Vivek B. Wani ◽

Arvind L. Tenagi

Keyword(s):

Visual Acuity ◽

Intravitreal Injection ◽

Macular Oedema ◽

Diabetic Macular Oedema ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Disadvantaged Population ◽

Corrected Visual Acuity ◽

Student’S T ◽

Best Corrected Visual Acuity

Background: The treatment of diabetic macular oedema (DMO) by intravitreal injection (IVI) of approved anti-vascular endothelial growth factor (VEGF) is costly and hence off label use of bevacizumab is practiced in spite of concerns about its safety.Aim: To examine the effect of three IVI of bevacizumab given monthly, on best corrected visual acuity (BCVA) and central foveal thickness (CFT) of eyes with DMO.Setting: Charity hospital attached to a medical college in India.Methods: Patients with centre involving DMO with BCVA ≤ 6/9 and CFT ≥ 260 microns were recruited prospectively, and three IVI bevacizumab given monthly (from a common vial). At four months BCVA and CFT were assessed and compared with baseline data. Side effects, if any, were recorded. Best corrected visual acuity was converted to logMAR units for statistical analysis. Student’s t-test were conducted to see statistically significant changes in BCVA and CFT.Results: A total of 50 eyes of 38 patients received three monthly IVI bevacizumab. Best corrected visual acuity (logMAR) improved from baseline mean of 0.80 ± 0.49 to final mean of 0.51 ± 0.36, which was significant (p = 0.0001). The mean baseline CFT (μm) improved from 448.40 ± 149.47 to 368.76 ± 131.49, which was significant (p = 0.0001). No cases of endophthalmitis were reported. Various factors such as diabetes duration and HbA1c (hemoglobinA1c) value were not found to be significant for the improvement in BCVA and CFT.Conclusion: Intravitreal injection bevacizumab given as three monthly injections was safe, economical and effective in the management of DMO.

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One-year real-life results on effect of intravitreal aflibercept in patients with diabetic macular oedema switched from ranibizumab

European Journal of Ophthalmology ◽

10.1177/1120672120927275 ◽

2020 ◽

pp. 112067212092727

Author(s):

Marko Lukic ◽

Gwyn Williams ◽

Zaid Shalchi ◽

Praveen J Patel ◽

Philip G Hykin ◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Early Treatment ◽

Macular Oedema ◽

Real Life ◽

Diabetic Macular Oedema ◽

Foveal Thickness ◽

Macular Volume ◽

Central Foveal Thickness ◽

The Mean

Purpose To assess visual and optical coherence tomography–derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®). Design Retrospective, cohort study. Participants Ninety eyes (of 67 patients) receiving intravitreal anti–vascular endothelial growth factor therapy were included. Methods This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given. Main Outcome Measures We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given. Results Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was −1.53 mm 3 in SW group (p = 0.21), while the change in central foveal thickness was −136.8 μm (p = 0.69). Conclusion There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.

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Extended real-world experience with the ILUVIEN® (fluocinolone acetonide) implant in the United Kingdom: 3-year results from the Medisoft® audit study

Eye ◽

10.1038/s41433-021-01542-w ◽

2021 ◽

Author(s):

Clare Bailey ◽

◽

Usha Chakravarthy ◽

Andrew Lotery ◽

Geeta Menon ◽

...

Keyword(s):

Macular Oedema ◽

Diabetic Macular Oedema ◽

Clinical Effectiveness ◽

Fluocinolone Acetonide ◽

Prior History ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Laser Trabeculoplasty ◽

Retrospective Audit ◽

History Of

Abstract Background This study aimed to assess the long-term effectiveness of the 0.2 μg/day fluocinolone acetonide (FAc) implant over ≥3 years for patients with diabetic macular oedema. Methods A retrospective audit of pseudo-anonymised data from patients with chronic diabetic macular oedema (cDMO) and treated with the FAc implant across 14 UK clinical sites. Safety and clinical effectiveness were measured. Results Two-hundred and fifty-six eyes had ≥3 years of follow-up (mean 4.28 years), during which a mean of 1.14 FAc implants were used per eye. Mean best-recorded visual acuity (BRVA) increased from 52.6 to 56.7 letters at month 3 and remained stable thereafter; this trend was also seen in pseudophakic eyes. The proportion of patients attaining a BRVA ≥6/12 increased from 17% at baseline to 27% 1 month after FAc implant and remained stable above 30% from month 12 onwards. Eyes with no prior history of intraocular pressure (IOP)-related events required significantly less treatment-emergent IOP-lowering medication than those with a prior history of IOP events (17.9% vs. 50.0% of eyes; p < 0.001). The incidence of an IOP increase of ≥10 mmHg, use of IOP-lowering medication, laser trabeculoplasty and IOP-lowering surgery was 28.9%, 29.7%, 0.8% and 2.7%, respectively, for the whole cohort. There were significant reductions in mean central foveal thickness and macular volume (p < 0.001). Conclusions The FAc implant was well tolerated, with predictable and manageable IOP-related events while delivering a continuous microdose of corticosteroid to eyes with cDMO, providing prolonged vision preservation and a reduced number of treatments.

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Prospective study of vitrectomy for epiretinal membranes in patients with good best-corrected visual acuity

10.21203/rs.2.9497/v1 ◽

2019 ◽

Author(s):

Hiroyuki Nakashizuka ◽

Yorihisa Kitagawa ◽

Yu Wakatsuki ◽

Koji Tanaka ◽

Koichi Furuya ◽

...

Keyword(s):

Visual Acuity ◽

Foveal Thickness ◽

Mixed Effect ◽

Epiretinal Membranes ◽

Central Foveal Thickness ◽

Mixed Effect Models ◽

Corrected Visual Acuity ◽

Good Group ◽

Final Observation ◽

Best Corrected Visual Acuity

Abstract Purpose: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA≦logMAR0.046 (Good group) to 35 patients with logMAR BCVA 0.52–0.10 (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery was effective for MH, BCVA, aniseikonia, and QOL.

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Bilateral fingolimod-associated macular oedema development after cataract surgery

BMJ Case Reports ◽

10.1136/bcr-2020-240562 ◽

2021 ◽

Vol 14 (6) ◽

pp. e240562

Author(s):

Matthew Gillam ◽

Theresa Richardson

Keyword(s):

Multiple Sclerosis ◽

Cataract Surgery ◽

Macular Oedema ◽

Topical Therapy ◽

Cystoid Macular Oedema ◽

Topical Steroids ◽

Visual Recovery ◽

Anti Inflammatory

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.

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Intravitreal triamcinolone acetonide for treatment of cystoid macular oedema in patients with retinitis pigmentosa

Acta Ophthalmologica Scandinavica ◽

10.1111/j.1600-0420.2005.00395.x ◽

2005 ◽

Vol 83 (2) ◽

pp. 248-251 ◽

Cited By ~ 49

Author(s):

Hakan Ozdemir ◽

Murat Karacorlu ◽

Serra Karacorlu

Keyword(s):

Retinitis Pigmentosa ◽

Triamcinolone Acetonide ◽

Macular Oedema ◽

Cystoid Macular Oedema ◽

Intravitreal Triamcinolone ◽

Intravitreal Triamcinolone Acetonide

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Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa

10.21203/rs.3.rs-63600/v1 ◽

2020 ◽

Author(s):

Lian Tan ◽

Yanling Long ◽

Ziyang Li ◽

Xi Ying ◽

Jiayun Ren ◽

...

Keyword(s):

Visual Acuity ◽

Retinitis Pigmentosa ◽

Macular Oedema ◽

Western China ◽

Vitreomacular Traction ◽

Cystoid Macular Oedema ◽

Epiretinal Membranes ◽

Ocular Abnormalities ◽

Vitreomacular Traction Syndrome ◽

Macular Holes

Abstract Background: To report the prevalence of ocular abnormalities and investigate visual acuity in a large Western China cohort of retinitis pigmentosa (RP) patients.Methods: A retrospective study was performed, reviewing the medical records and ophthalmic examination reports of 2,127 eyes from 1,065 RP patients in one eye hospital. The authors investigated the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities.Results: Nyctalopia (58.2%) and blurred vision (27.1%) were the leading consultation causes. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were cataracts (43.1%) and macular abnormalities (59.7%), including epiretinal membranes (51.1%), cystoid macular oedema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (P = 0.001) and macular holes (P = 0.008) increased significantly with age. The proportions of vitreomacular traction syndrome (P = 0.003) and epiretinal membranes (P < 0.001) in pseudophakia and aphakia eyes were significantly higher than in eyes that had not received operations (including cataracts and clear lens). Cystoid macular oedema was significantly associated with poorer visual acuity in RP patients with clear lens (P = 0.002).Conclusion: Cataracts and macular abnormalities are common in RP patients. In the macular abnormalities, cystoid macular oedema may have a negative effect on BCVA in RP patients with clear lens.

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DYNAMICS OF THE COURSE OF RETINITIS PIGMENTOSA IN A CHILD WITH MACULAR INVOLVEMENT OVER 6 YEARS.

Ophthalmology Cases & Hypotheses ◽

10.30546/2788-516x.2021.2.1.1 ◽

2021 ◽

Vol Volume 2 (Fall) ◽

pp. 1-4

Author(s):

Nushaba Hasan Nuri

Keyword(s):

Retinitis Pigmentosa ◽

Macular Oedema ◽

Cystoid Macular Oedema ◽

Early Progression

Purpose: The purpose of this work was to describe retinitispigmentosa involving themaculain a child with a follow-upof6years.Methods: Casereport.Results: Over 6 years, the child exhibited an expansion of thelesionareaofthecentralretina.Onopticalcoherencetomography (OCT), there is a sharp thinning of the centralregion of the retina with pathology of the photoreceptorandpigmentlayers.Conclusion: In some cases of retinitis pigmentosa, there arechangesinthemacula,characteristicofthedryformofmaculardegeneration; in other cases, there are cysts associatedwith cystoid macular oedema; and in other cases, there is amacularhole.Inourcase,therewasanatrophiclesionofthemacula,characteristicofthedryformofage-relatedmaculardegeneration. Apparently, such involvement of the macula inthe process is typical for children with early progression of thedisease.

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Prospective study of vitrectomy for epiretinal membranes in patients with good best-corrected visual acuity

10.21203/rs.2.9497/v3 ◽

2019 ◽

Author(s):

Hiroyuki Nakashizuka ◽

Yorihisa Kitagawa ◽

Yu Wakatsuki ◽

Koji Tanaka ◽

Koichi Furuya ◽

...

Keyword(s):

Visual Acuity ◽

Foveal Thickness ◽

Mixed Effect ◽

Epiretinal Membranes ◽

Central Foveal Thickness ◽

Mixed Effect Models ◽

Corrected Visual Acuity ◽

Good Group ◽

Final Observation ◽

Best Corrected Visual Acuity

Abstract Backgroud: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA ≦ 0.046 logMAR (Good group) to 35 patients with 0.10 - 0.52 logMAR (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery for patients with BCVA ≦ 0.046 logMAR was effective for improvement of HM, BCVA, and QOL and prevented worsening of aniseikonia.

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