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Original article
Efficacy of additional topical betamethasone in persistent cystoid macular oedema after carbonic anhydrase inhibitor treatments in retinitis pigmentosa
  1. Shohei Kitahata1,2,
  2. Yasuhiko Hirami1,3,
  3. Seiji Takagi1,3,
  4. Cody Kime2,
  5. Masashi Fujihara1,3,
  6. Yasuo Kurimoto1,3,
  7. Masayo Takahashi1,2
  1. 1 Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan
  2. 2 Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Kobe, Japan
  3. 3 Department of Ophthalmology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
  1. Correspondence to Dr Yasuhiko Hirami; yhirami{at}kcho.jp

Abstract

Objective We investigated the efficacy of additional topical betamethasone in persistent cystoid macular oedema (CMO) after carbonic anhydrase inhibitors (CAIs) therapy.

Methods and analysis This 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.

Results In 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.

Conclusion Our data suggested that additional betamethasone might improve treatments for persistent CMO. Topical steroids could be an alternative option for managing persistent CMO in RP.

  • retina
  • treatment medical
  • drugs

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjophth-2017-000107

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    Footnotes

    • Contributors YH and MT conceived and designed the experiments. SK, YH and ST took an active part in conduct, data analysis and publication drafting the data. SK and ST wrote the manuscript and YH, CK, MF, YK and MT reviewed the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study protocol was approved by the Kobe City Medical Center General Hospital ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.