A randomized, masked, cross-over trial of lisinopril for inflammatory macular edema.
OBJECTIVE
To analyze the effect of angiotensin-converting enzyme (ACE) inhibitor lisinopril on inflammatory cystoid macular edema and visual acuity.


METHODS
Randomized, double-blind, placebo-controlled cross-over trial.


METHODS
setting: Outpatient clinic of the Department of Ophthalmology at the University Medical Center of Utrecht. patients: Forty patients with inflammatory cystoid macular edema were included. intervention: Each patient received lisinopril (10 mg daily) or placebo for three months. After two months of a lisinopril/placebo free wash-out period, the groups received the reverse study medication for three months. Fluorescein angiography was performed to evaluate the retina. main outcome measures: Cystoid macular edema, best-corrected visual acuity and contrast sensitivity.


RESULTS
Lisinopril had no effect on cystoid macular edema, visual acuity, papillary leakage, retinal vasculitis, and choroidal leakage. In a subgroup analysis, we observed a decrease in blood pressure (lisinopril, 14 of 36 patients; placebo, 5 of 36 patients; P = .02) and a decrease in morning urinary albumin excretion (lisinopril, 23 of 35 patients; placebo 10 of 34 patients, P = .003) was observed.


CONCLUSIONS
Although lisinopril had no effect on inflammatory cystoid macular edema and visual acuity, we found a positive effect on the vascular system.
F.C. Donders Institute of Ophthalmology, Department of Hematology, University Medical Center, Utrecht, The Netherlands. b.vankooij@oogh.azu.nl
Bram
B
van Kooij
Rob
R
Fijnheer
Joke
J
de Boer
Ninette
N
ten Dam-van Loon
Imke
I
Bartelink
Mark
M
Roest
Aniki
A
Rothova
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000378:metabolism; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015350:Contrast Sensitivity; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017706:Lisinopril / Q000627:therapeutic use*; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D031300:Retinal Vasculitis / Q000188:drug therapy*; D014792:Visual Acuity / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D017706:Lisinopril