Efficacy of sustained topical dorzolamide therapy for cystic macular lesions in patients with retinitis pigmentosa and usher syndrome.

Abstract

OBJECTIVE:

To determine the efficacy of sustained topical therapy with dorzolamide hydrochloride, 2%, on visual acuity and cystic macular lesions in patients with retinitis pigmentosa and Usher syndrome.

METHODS:

In a retrospective case series at a university hospital, 64 eyes of 32 patients with retinitis pigmentosa or Usher syndrome receiving treatment with the topical dorzolamide formulation for 6 to 58 months were enrolled. Changes in visual acuity on the Early Treatment Diabetic Retinopathy Study chart and central foveal zone thickness on optical coherence tomography were measured during follow-up for the duration of treatment.

RESULTS:

Among the study cohort, 20 of 32 patients (63%) showed a positive response to treatment in at least 1 eye and 13 patients (41%) showed a positive response in both eyes. Four patients (20%) showed an initial response and a subsequent rebound of macular cysts. In 8 patients (25%), there was no response to treatment and the macular cysts worsened when compared with the pretreatment level. Ten patients (31%) had improvement in visual acuity by 7 or more letters in at least 1 eye at the most recent follow-up visit. Sixteen patients (67%) showed a reduction of more than 11% in the central foveal zone thickness in at least 1 eye when compared with the pretreatment level.

CONCLUSIONS:

Patients with either retinitis pigmentosa or Usher syndrome who received treatment of cystoid macular edema with topical dorzolamide followed by an optical coherence tomography-guided strategy showed a decrease in central foveal zone thickness in most cases. Visual acuity improved in almost one-third of the cases, suggesting a potential corresponding visual benefit.

• Authors: Mohamed A Genead, Gerald A Fishman
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 128 Issue 9 Pg. 1146-50 (Sep 2010) ISSN: 1538-3601 [Electronic] United States
• PMID: 20837798 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Carbonic Anhydrase Inhibitors
• Ophthalmic Solutions
• Sulfonamides
• Thiophenes
• dorzolamide

Topics

• Administration, Topical
• Adult
• Aged
• Carbonic Anhydrase Inhibitors (administration & dosage, therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Macular Edema (diagnosis, drug therapy, etiology)
• Male
• Middle Aged
• Ophthalmic Solutions (administration & dosage, therapeutic use)
• Retina (pathology)
• Retinitis Pigmentosa (complications)
• Retrospective Studies
• Sulfonamides (administration & dosage, therapeutic use)
• Thiophenes (administration & dosage, therapeutic use)
• Tomography, Optical Coherence
• Treatment Outcome
• Usher Syndromes (complications)
• Visual Acuity (physiology)
• Young Adult