Is acetazolamide effective in the treatment of diabetic macular edema? A pilot study

被引:30
作者
Giusti C. [1 ]
Forte R. [1 ]
Vingolo E.M. [1 ]
Gargiulo P. [2 ]
机构
[1] Department of Ophthalmology, University 'La Sapienza', Rome
[2] Institute of Internal Medicine II, University 'La Sapienza', Rome
关键词
Acetazolamide; Carbonic anhydrase inhibitors; Diabetic macular edema; Diabetic retinopathy; Fluorescein angiography; Retina;
D O I
10.1023/A:1016354517304
中图分类号
学科分类号
摘要
Aim: To investigate whether acetazolamide, already found to be helpful in decreasing cystoid macular edema in patients with retinitis pigmentosa, was also effective in the treatment of diabetic macular edema in nonproliferative retinopathy. Methods: Two randomized age- and sex-matched groups (cases and controls) of 12 diabetics (five Type 1 and seven Type 2) were selected for this pilot study and graded for retinopathy (Early Treatment of Diabetic Retinopathy Study - Airlie House Classification). Cases were treated with acetazolamide for three months according to a standard protocol. The Early Treatment of Diabetic Retinopathy Study chart was used for assessing far-best corrected visual-acuity, and fluorescein angiography was performed using the Heidelberg Retina Angiograph. The Amsler grid-test and computerized-perimetry (Octopus 2000R) were also performed. Results: Fluorescein-angiographic findings and perimetric data improved significantly (p < 0.01) in the acetazolamide-treated cases compared to the controls while visual-acuity varied only slightly (p > 0.01). The Amsler grid-test resulted insignificant in our study (p > 0.05). No adverse effects or significant variations in laboratory tests were recorded. Conclusion: Further clinical investigations involving larger numbers of patients and a longer follow-up are required to confirm these preliminary results. However, the present study seems to suggest that acetazolamide could be effective in reducing fluorescein-angiographic findings and improving perimetric data in diabetics with macular edema, even though the mechanism of action remains obscure. Visual-acuity varied only slightly.
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页码:79 / 88
页数:9
相关论文
共 21 条
[1]  
Farber M.D., Lam S., Tessler H.R., Jennings T.J., Cross A., Rusin M.M., Reduction of macular edema by acetazolamide in patients with chronic iridocyclitis: A randomised prospective cross-over study, Br J Ophthalmol, 78, pp. 4-7, (1994)
[2]  
Fishman G.A., Gilbert L.D., Anderson R.J., Marmor M.F., Weleberg R.G., Viana M.A., Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa, Ophthalmology, 101, pp. 687-693, (1994)
[3]  
Miyake Y., Awaya S., Takahashi H., Tomita N., Hirano K., Hyperbaric oxygen and acetazolamide improve visual acuity in patients with cystoid macular edema by different mechanisms, Arch Ophthalmol, 111, pp. 1605-1606, (1993)
[4]  
Fishman G.A., Glenn A.M., Gilbert L.D., Rebound of macular edema with continued use of methazolamide in patients with retinitis pigmentosa, Arch Ophthalmol, 111, pp. 1640-1646, (1993)
[5]  
Grover S., Fishman G.A., Fiscella R.G., Adelman A.E., Efficacy of dorzolamide hydrochloride in the management of chronic cystoid macular edema in patients with retinitis pigmentosa, Retina, 17, pp. 222-231, (1997)
[6]  
Moss S.E., Klein R., Klein B.E.K., The 14-year incidence of vision loss in a diabetic population, Ophthalmology, 105, pp. 998-1003, (1998)
[7]  
Farly photocoagulation for diabetic retinopathy ETDRS report No. 9, Ophthalmology, 98, pp. 766-785, (1991)
[8]  
Classification of diabetes mellitus and other categories of glucose intolerance, Diabetes, 28, pp. 1039-1057, (1979)
[9]  
Mogensen C.E., Schmitz O., The diabetic kidney: From hyperfiltration and microalbuminuria to end-stage renal failure, Med Clin North Am, 72, (1988)
[10]  
Pannarale L., Forte R., Giusti C., Vingolo E.M., The effectiveness of acetazolamide in the treatment of diabetic macular edema, Proceedings of the Symposium on Vitreoretinal Diseases and Surgery - 5th Biennial Schepens International Society Meeting 1995 March 1-5