Comparison of topical dorzolamide and ketorolac treatment for cystoid macular edema in retinitis pigmentosa and Usher's syndrome

To investigate the topical effect of dorzolamide versus ketorolac on retinitis pigmentosa (RP) and Usher's syndrome (US) macular edema. Prospective, randomized and interventional study. A total of 28 eyes of 18 patients were included. Five eyes had US, 23 had RP. Fifteen eyes were allocated to...

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Bibliographic Details
Published in:	Ophthalmologica (Basel) Vol. 233; no. 1; p. 43
Main Authors:	Lemos Reis, Ricardo Filipe, Moreira-Gonçalves, Nuno, Estrela Silva, Sérgio E, Brandão, Elisete M, Falcão-Reis, Fernando M
Format:	Journal Article
Language:	English
Published:	Switzerland 01-01-2015
Subjects:	Administration, Topical Adult Aged Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Carbonic Anhydrase Inhibitors - therapeutic use Female Fovea Centralis - pathology Humans Ketorolac Tromethamine - therapeutic use Macular Edema - drug therapy Macular Edema - physiopathology Male Middle Aged Ophthalmic Solutions Prospective Studies Retinitis Pigmentosa - complications Retinitis Pigmentosa - physiopathology Sulfonamides - therapeutic use Thiophenes - therapeutic use Tomography, Optical Coherence Usher Syndromes - complications Usher Syndromes - physiopathology Visual Acuity - physiology Visual Field Tests Visual Fields - physiology Young Adult
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Summary:	To investigate the topical effect of dorzolamide versus ketorolac on retinitis pigmentosa (RP) and Usher's syndrome (US) macular edema. Prospective, randomized and interventional study. A total of 28 eyes of 18 patients were included. Five eyes had US, 23 had RP. Fifteen eyes were allocated to ketorolac tromethamine 0.5% (4 drops daily regimen) and 13 eyes to dorzolamide hydrochloride 2% (3 drops daily regimen) treatment groups. Snellen's best-corrected visual acuity (BCVA), foveal thickness (FT) and foveal zone thickness (FZT) measured by Stratus® optical coherence tomography (OCT) were evaluated at baseline, 1, 3, 6 and 12 months after treatment. Patients assigned to ketorolac had a baseline BCVA of 0.37 ± 0.17 logMAR which improved at the end of 1 year to 0.28 ± 0.16 (p = 0.02). Three eyes (20%) of 2 patients improved by 7 letters or more. Mean FT and FZT did not change significantly during the study follow-up. After 1 year of treatment, 4 eyes (27%) of 3 patients showed an improvement of at least 16% of FT and 11% of FZT. Patients assigned to dorzolamide had a baseline BCVA of 0.48 ± 0.34 logMAR which improved in the first 6 months (0.40 ± 0.30; p = 0.01), with a decrease at 1 year (0.42 ± 0.27; p = 0.20). Seven eyes (54%) of 5 patients had an improvement of 7 letters or more. Mean FT and FZT did not change significantly either. After 1 year of treatment, 3 eyes (23%) of 2 patients showed an improvement of at least 16% on FT and 11% on FZT. RESULTS suggest that dorzolamide and ketorolac might improve visual acuity and therefore be of interest in selected cases. No relationship between retinal thickness fluctuation and visual acuity was found. Sample size was a limitation to the study.
ISSN:	1423-0267
DOI:	10.1159/000368052