Resolution of Unilateral Dome-Shaped Macula With Serous Detachment After Treatment of Topical Carbonic Anhydrase Inhibitors

Chen, Nan Ni; Chen, Ching Lung; Lai, Chien Hsiung

doi:10.3928/23258160-20190806-16

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…Different therapies have been proposed for SRF complicating dome-shaped macula, including photodynamic therapy, 242,243 spironolactone, 244 aflibercept, 245 and topical carbonic anhydrase inhibitors. 246 A transient improvement has been observed after surgery for epiretinal membrane. 247 However, all studies were case reports or small series and no comparison with a control group was performed.…”

Section: Dome-shaped Maculamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

213

159

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Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy. Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.

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Section: Dome-shaped Maculamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

213

159

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“…The efficacy of topical monotherapy with CAIs has been reported in several conditions [ 59 ]. The effect of CAIs on retinal edema has been shown in RP with Usher syndrome [ 32 ]; choroideremia [ 60 ]; syndromic retinal dystrophies, such as Alström syndrome [ 61 ]; CME after cataract extraction [ 62 ]; and serous retinal detachment secondary to a dome-shaped macula [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

Carbonic anhydrase inhibitors in the management of macular edema: A review of the literature

Shahsuvaryan¹

2022

Med Hypothesis Discov Innov Ophthalmol

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Background: Macular edema (ME) is a vision-threatening condition that commonly develops as a consequence of ocular diseases, including age-related macular degeneration, retinal vaso-occlusion of the central retinal vein and its branches, diabetic retinopathy, central serous chorioretinopathy, uveitis, retinitis pigmentosa, pseudophakia, ocular trauma, and drug toxicity. The treatment of ME remains challenging, although steroids and vascular endothelial growth factor inhibitors are available. Cost-effective therapy using a noninvasive administration route is required. This study aimed at reviewing the role of carbonic anhydrase inhibitors (CAIs) in the management of ME. Methods: A literature search was conducted using PubMed/MEDLINE and Google Scholar for studies from January 2000 to March 2022. The following keywords were used in various combinations: “macular edema”, “carbonic anhydrase”, “carbonic anhydrase inhibitors”, “acetazolamide”, “dorzolamide”, and “brinzolamide”. Results: Articles with high or medium clinical relevance were selected for this review. We found that multiple studies have demonstrated the relevance and efficacy rates of CAIs in the management of ME. Most published studies focused on acetazolamide and dorzolamide, with nearly all studies reporting therapeutic responses. Conclusions: ME is the leading cause of vision loss and requires noninvasive and cost-effective pharmacotherapy. With progress in the understanding of ME, particularly the role of carbonic anhydrase as a key driver, CAIs are the focus of research. Further optimization of the choice of CAIs and retinal bioavailability, potentially with nanoparticle formulations, is required to enable the effective management of ME. Further research is warranted to address the therapeutic effects of CAIs in different formulations.

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“…CAIs have widely been used as an adjunct for the treatment of macular cysts in various retinal pathologies 10. Chen et al reported a case of unilateral DSM with SRF, which responded to topical therapy with CAIs 3. Mechanism of action of CAIs in the resolution of SRF is not clearly established, though probable theories include restoring normal polarity of retinal pigment epithelium cells, vascular dilatation, accelerated blood flow and thus possible limited remission of scleral compression maculopathy 3 11…”

Section: Discussionmentioning

confidence: 99%

“…Multiple treatment modalities have been advocated in the management of SFD with SRF with variable success. Administration of topical carbonic anhydrase inhibitor (CAI) for DSM with SRF seems to have positive outcomes 3. We report a case of a 5-year-old child diagnosed with myopic DSM with bilateral intraretinal foveal cyst, which responded to topical dorzolamide with improvement in visual acuity.…”

Section: Introductionmentioning

confidence: 99%

Resolution of bilateral foveal cysts in dome-shaped macula after treatment with topical dorzolamide

et al. 2021

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Dome-shaped macula (DSM) is characterised by a convex anterior bulging of the macular area. It can further get complicated by accumulation of subretinal fluid (SRF). Foveal cysts that are bilateral, in a setting of DSM, are an entity not yet reported. Management options for DSM with SRF showed variable success. Topical carbonic anhydrase inhibitors (CAIs) have been successful in treating certain macular pathologies. The authors report a rare case of bilateral intraretinal foveal cyst in a myopic child with DSM with favourable response to topical dorzolamide. Topical CAIs may be considered a safe and effective option in such cases.

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Resolution of Unilateral Dome-Shaped Macula With Serous Detachment After Treatment of Topical Carbonic Anhydrase Inhibitors

Cited by 8 publications

References 13 publications

IMI Pathologic Myopia

IMI Pathologic Myopia

Carbonic anhydrase inhibitors in the management of macular edema: A review of the literature

Resolution of bilateral foveal cysts in dome-shaped macula after treatment with topical dorzolamide

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