Título / Title

INTRAVITREAL ACETAZOLAMIDE IMPLANT FOR PSEUDOPHAKIC CYSTOID MACULAR EDEMA

Introdução / Purpose

To test the safety of intravitreal use of acetazolamide implant (260 μg) for the treatment of cystoid macular edema refractory or relapsing or intolerant to traditional treatment.

Material e Método / Methods

An intravitreal acetazolamide implant was performed after patients’ agreement: The implant containing 260 μg of acetazolamide was placed via pars plana into the vitreous cavity, using a 25-gauge trocar-cannula (Alcon, Fortworth, Texas). Follow-up was performed with ophthalmologic examination, optical coherence tomography, electroretinogram, and laboratory tests.

Resultados / Results

So far, 2 patients completed the 6-month follow-up period. After 6 months there was no change in the electroretinogram of both initial patients as well as in the laboratory tests. In the first patient, there was a progressive reduction of cystoid macular edema: central subfield thickness at baseline was 605 μm and reduced to 269 μm 6 months after implant insertion and the BCVA has improved from 20/40 to 20/20 in the same period. This patient also had 03 mmHg of IOP pressure reduction at the same time interval. In the second patient: central subfield thickness at baseline was 675 μm and the BCVA was 20/800. Six months after the implant insertion the subfield thickness was 548 μm and the BCVA was 20/800. The edema had completely regressed by 18 months (central subfield thickness: 228 μm), with the patient presenting with BCVA 20/100.

Discussão e Conclusões / Conclusion

We show that PCME refractory to conventional treatment could be improved after an intravitreal acetazolamide implant. More studies and cases are warranted to confirm these early preliminary findings.

Palavras Chave

pseudophakic macular edema, drug system delivery, cataract

Area

CLINICAL RETINA

Institutions

HCRP USP - Ribeirão Preto - São Paulo - Brasil

Authors

ISABELA FRANCO VILLELA, RODRIGO JORGE, CHRISTIAN FERNANDES, THAIS BASTOS, INGRID SCOTT, ARMANDO CUNHA, SILVIA FIALHO, ANDRE MESSIAS