Optical coherence tomography in the diagnosis and monitoring of cystoid macular edema in patients with retinitis pigmentosa.

Abstract

To identify cystoid macular edema (CME) in patients with retinitis pigmentosa (RP) using optical coherence tomography (OCT) and to evaluate response to acetazolamide by serial OCT. Twenty-nine consecutive RP patients were included in the study. Patients with CME were treated with acetazolamide (125 or 250 mg/d for 4-12 months). OCT, fluorescein angiography, and determination of best-corrected visual acuity (BCVA) were performed initially and throughout the follow-up period. Ten of the 29 patients had CME by OCT. Of these 10 patients, 5 had various degrees of fluorescein leakage by fluorescein angiography. After acetazolamide treatment, six patients had significant decreases in macular edema in at least one eye by follow-up OCT. In six patients, visual acuity improved by > or =1 line in at least one eye. The change of central foveal thickness shown by OCT was significantly correlated with the change of logMAR of BCVA (Pearson correlation coefficient [r] = 0.576; P = 0.008). We observed no differences in the change of central foveal thickness by OCT (Mann-Whitney test; P = 1.000) and in the change of logMAR of BCVA (Mann-Whitney test; P = 0.106) between patients treated with 125 mg/d acetazolamide and those treated with 250 mg/d acetazolamide. These results indicate that OCT is a valuable tool in the detection and follow-up of CME in RP patients. Treatment with acetazolamide resulted in marked improvement in OCT-diagnosed CME in RP, but visual improvement was variable.