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      Topical dorzolamide for the treatment of cystoid macular edema in patients with retinitis pigmentosa.

      American Journal of Ophthalmology

      Administration, Topical, Adolescent, Adult, Carbonic Anhydrase Inhibitors, therapeutic use, Diagnostic Techniques, Ophthalmological, Female, Humans, Macular Edema, complications, diagnosis, drug therapy, Male, Middle Aged, Prospective Studies, Retinitis Pigmentosa, Sulfonamides, Thiophenes, Tomography, Optical Coherence, Visual Acuity

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          To determine if topical dorzolamide, as observed with the use of systemic acetazolamide and methazolamide, would be effective in treating cystoid macular edema (CME) in patients with retinitis pigmentosa (RP). Prospective, nonrandomized clinical trial. setting: Institutional. patients: Fifteen patients with CME and RP. intervention: A baseline visual acuity and optical coherence tomography (OCT) measurements were obtained in all patients. Each one of them was then treated with topical dorzolamide, three times a day, for at least four weeks in both eyes. main outcome measures: Significant decrease in "foveal thickness" (more than 16%) and "foveal zone thickness" (more than 11%), as measured by OCT. Thirteen (87%) of 15 patients showed a significant decrease in retinal thickness in at least one eye after use of topical dorzolamide for at least four weeks. Five patients (33%) demonstrated improvement in both eyes. All patients, except one, who responded showed the effect within four weeks, but were monitored for a period of two to nine months (average 4.5 months). Four patients (31%) who showed an initial improvement in macular edema showed worsening with continued treatment. The present study documents the potential efficacy of topical dorzolamide for treating CME in patients with RP. We observed that some patients may show a "rebound phenomenon" with continued use of the medication; hence, there is a need for careful follow-up in patients being treated.

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