Monitoring cystoid macular edema by optical coherence tomography in patients with retinitis pigmentosa

Purpose: To determine the value of optical coherence tomography (OCT) imaging in the diagnosis and monitoring of cystoid macular edema (CME) in patients with retinitis pigmentosa (RP). Design: Prospective, noncomparative, small case series. Participants: Three patients with RP and cystic-appearing spaces in the macula on OCT images. Intervention: All 3 patients were treated with a carbonic anhydrase inhibitor, and 1 also received topical and systemic steroids. Main Outcome Measures: Changes in OCT images, fluorescein angiography, and best-corrected visual acuity (VA). Results: Although foveal cysticlike spaces were evident on OCT images in all 3 patients, only 1 patient showed CME on fluorescein angiography at baseline. Two of the 3 patients showed funduscopic evidence of macular cystic lesions, whereas a third showed no clinically evident fundus changes in the macula. Optical coherence tomography images documented improvement in the cystic-appearing spaces after treatment with the carbonic anhydrase inhibitor. Changes on fluorescein angiography were either not apparent or considerably less apparent. An improvement of greater than or equal to1 line on a Snellen acuity chart was recorded in 2 patients, whereas a third showed no change of VA in either eye. Conclusions: Optical coherence tomography is a potential method for the diagnosis and monitoring of CME in patients with RP. It was more sensitive in this regard than either fluorescein angiography or funduscopic examination. (C) 2004 by the American Academy of Ophthalmology.