Topical nepafenac as an alternate treatment for cystoid macular edema in steroid responsive patients.
OBJECTIVE
To evaluate the use of nepafenac 0.1% in patients with cystoid macular edema who are known steroid responders.


METHODS
Patients (N = 15) with clinical and angiographic cystoid macular edema (> or = 2 months) and a history of increased intraocular pressure following administration of topical corticosteroids participated in this prospective, open-label, pilot study. All patients were treated with nepafenac 0.1% four times daily for 6 weeks and the dose was tapered off over the ensuing 6 weeks. The total treatment duration was 12 weeks. Visual acuity and retinal thickness were measured.


RESULTS
For the entire population, there was a mean significant improvement in visual acuity and retinal thickness at 4 weeks and 12 weeks posttreatment compared with baseline (P < 0.0001). A subgroup analysis revealed that patients with pseudophakic cystoid macular edema (n = 11) had a mean significant improvement in visual acuity and retinal thickness compared with baseline at 4 weeks and 12 weeks posttreatment (P < 0.0001). Although the improvement in the vitreoretinal interface disorders group was not statistically different from baseline (probably due to the outlier), three of the four patients with vitreoretinal interface disorders had improvement in visual acuity and retinal thickness. Nepafenac was well tolerated.


CONCLUSIONS
Nepafenac may be an effective and safe therapy for treating chronic cystoid macular edema in patients who are steroid responders.
Warren
Keith A
KA
Department of Ophthalmology, University of Kansas School of Medicine, Kansas City, USA. kwarren@warrenretina.com
Fox
Jenni E
JE
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D044482:Benzeneacetamides / Q000008:administration & dosage / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000009:adverse effects; D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D010648:Phenylacetates / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D019591:Pseudophakia / Q000209:etiology; D012160:Retina / Q000187:drug effects / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D009883:Ophthalmic Solutions; D010648:Phenylacetates; C414203:nepafenac