Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa

G. A. Fishman, L. D. Gilbert, R. J. Anderson, M. F. Marmor, Richard Weleber, M. A G Viana

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the effectiveness of methazolamide for improving visual acuity and macular edema in patients with retinitis pigmentosa. Methods: Seventeen subjects with retinitis pigmentosa and chronic macular edema participated in a prospective, placebo-controlled, double-masked, crossover design study in which either methazolamide or a placebo was taken for 3 weeks. Visual acuity, fluorescein angiograms, and subjective impressions were obtained at baseline and after 3 weeks of treatment with each substance. A subgroup of subjects were enrolled in a more extended period of methazolamide treatment for an additional 3 months. Results: Methazolamide resulted in the improvement of angiographic macular edema in 9 of 17 subjects. As a group, visual acuity statistically improved with methazolamide. However, improvement in at least one eye, of between two and four lines more than while taking placebo, occurred in only three (undilated pupils) or four (dilated pupils) subjects. Subjective improvement during treatment with methazolamide but not placebo occurred in only one subject. An extended period of methazolamide treatment for an additional 3 months in a subgroup of patients did not result in additional beneficial effects on visual acuity. In fact, a partial rebound in the extent of macular edema was found. Conclusions: Although angiographic improvement of macular edema can occur in patients with retinitis pigmentosa treated with methazolamide, notable (between 3 and 4 lines) or even moderate (between 2 and 3 lines) visual acuity improvement was seen in relatively few patients. When methazolamide was administered in a placebo-controlled fashion, subjective improvement in visual function also was not readily apparent. A more substantial subjective improvement in visual function had occurred with the use of acetazolamide in five of six subjects who also had participated in a previous treatment trial with the use of acetazolamide.

Original languageEnglish (US)
Pages (from-to)687-693
Number of pages7
JournalOphthalmology
Volume101
Issue number4
StatePublished - 1994

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Methazolamide
Retinitis Pigmentosa
Macular Edema
Visual Acuity
Placebos
Acetazolamide
Pupil
Cross-Over Studies
Therapeutics
Fluorescein
Angiography

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Fishman, G. A., Gilbert, L. D., Anderson, R. J., Marmor, M. F., Weleber, R., & Viana, M. A. G. (1994). Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa. Ophthalmology, 101(4), 687-693.

Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa. / Fishman, G. A.; Gilbert, L. D.; Anderson, R. J.; Marmor, M. F.; Weleber, Richard; Viana, M. A G.

In: Ophthalmology, Vol. 101, No. 4, 1994, p. 687-693.

Research output: Contribution to journalArticle

Fishman, GA, Gilbert, LD, Anderson, RJ, Marmor, MF, Weleber, R & Viana, MAG 1994, 'Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa', Ophthalmology, vol. 101, no. 4, pp. 687-693.
Fishman GA, Gilbert LD, Anderson RJ, Marmor MF, Weleber R, Viana MAG. Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa. Ophthalmology. 1994;101(4):687-693.
Fishman, G. A. ; Gilbert, L. D. ; Anderson, R. J. ; Marmor, M. F. ; Weleber, Richard ; Viana, M. A G. / Effect of methazolamide on chronic macular edema in patients with retinitis pigmentosa. In: Ophthalmology. 1994 ; Vol. 101, No. 4. pp. 687-693.
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AB - Purpose: To determine the effectiveness of methazolamide for improving visual acuity and macular edema in patients with retinitis pigmentosa. Methods: Seventeen subjects with retinitis pigmentosa and chronic macular edema participated in a prospective, placebo-controlled, double-masked, crossover design study in which either methazolamide or a placebo was taken for 3 weeks. Visual acuity, fluorescein angiograms, and subjective impressions were obtained at baseline and after 3 weeks of treatment with each substance. A subgroup of subjects were enrolled in a more extended period of methazolamide treatment for an additional 3 months. Results: Methazolamide resulted in the improvement of angiographic macular edema in 9 of 17 subjects. As a group, visual acuity statistically improved with methazolamide. However, improvement in at least one eye, of between two and four lines more than while taking placebo, occurred in only three (undilated pupils) or four (dilated pupils) subjects. Subjective improvement during treatment with methazolamide but not placebo occurred in only one subject. An extended period of methazolamide treatment for an additional 3 months in a subgroup of patients did not result in additional beneficial effects on visual acuity. In fact, a partial rebound in the extent of macular edema was found. Conclusions: Although angiographic improvement of macular edema can occur in patients with retinitis pigmentosa treated with methazolamide, notable (between 3 and 4 lines) or even moderate (between 2 and 3 lines) visual acuity improvement was seen in relatively few patients. When methazolamide was administered in a placebo-controlled fashion, subjective improvement in visual function also was not readily apparent. A more substantial subjective improvement in visual function had occurred with the use of acetazolamide in five of six subjects who also had participated in a previous treatment trial with the use of acetazolamide.

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