This retrospective study examines the effects of oral acetazolamide on patients with refractory inflammatory macular edema.

Study design

The authors reviewed records from 19 eyes (16 patients) with uveitic or pseudophakic macular edema, who were treated with acetazolamide over a 7-year period. Visual acuity and macular subfield thickness were measured at baseline and at first follow-up. The authors also examined baseline OCT features as predictors of acetazolamide response.

Outcomes

The mean central macular thickness decreased significantly, from 471 μm to 358 μm. Average visual acuity improved from 20/54 to 20/37.

Pretreatment OCT revealed intraretinal fluid in all patients, subretinal fluid in 42%, epiretinal membrane in 68%, and vitreomacular traction in 5%. However, OCT findings did not predict response to therapy.

Limitations

The retrospective nature of this study and its restriction to tertiary practice limited the scope of the findings and the conclusions that can be drawn.

Clinical significance

Patients with inflammatory macular edema may benefit from acetazolamide, which limits steroid resistance or corticosteroid-related complications, such as ocular hypertension, glaucoma, or cataract. Larger studies are needed to better compare this therapy with other treatment protocols.