dorzolamide and Retinal-Perforations

To determine whether a single topical aqueous suppressant applied immediately after pars plana vitrectomy with long-acting gas tamponade prevents intraocular pressure (IOP) elevation.. Fifty patients who met the inclusion criteria and underwent pars plana vitrectomy with long-acting gas tamponade were randomized to receive a combination of timolol maleate and dorzolamide hydrochloride, long-acting timolol alone, dorzolamide alone, or placebo at the conclusion of surgery. The IOP was checked by a portable, handheld tonometer (Tono-Pen) at the conclusion of surgery and at 5 hours, 1 day, and 1 week after surgery.. There were no significant differences in IOP among the groups at the conclusion of surgery. The IOP at 5 hours after surgery (27.0 vs 17.4 mm Hg; P<.001) and 1 day after surgery (26.1 vs 19.9 mm Hg; P =.01) showed a statistically significant difference between the placebo and timolol-dorzolamide groups. The timolol-dorzolamide group showed greater IOP control than either the timolol alone or the dorzolamide alone groups at 5 hours (P =.04 for both).. The use of a single topical aqueous suppressant (timolol-dorzolamide) given after pars plana vitrectomy with long-acting gas tamponade effectively prevents significant postoperative IOP elevation at 5 hours and 1 day after surgery.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Drug Therapy, Combination; Female; Fluorocarbons; Humans; Intraocular Pressure; Male; Middle Aged; Postoperative Complications; Postoperative Period; Prospective Studies; Retinal Detachment; Retinal Perforations; Sulfonamides; Sulfur Hexafluoride; Thiophenes; Timolol; Vitrectomy

This article reports two cases reported of combined treatment with topical dorzolamide and intravitreal bevacizumab injections, successfully treating small full-thickness macular hole without the need for traditional macular hole surgery.. This study aimed to report the potential effectiveness of combination treatment with topical dorzolamide and bevacizumab intravitreal injection therapy for small macular holes.. Case 1 was a 68-year-old woman presented with distorted and decreased vision in her right eye for 9 months. Fundus examination showed a full-thickness macular hole, which was confirmed with spectral domain optical coherence tomography measuring 96 μm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete hole closure and visual improvement in just 1 month. Case 2 was a 73-year-old woman who presented with distorted and decreased vision in her right eye for 8 months. Fundus examination showed a full-thickness macular hole in the right eye, confirmed with spectral domain optical coherence tomography, measuring 76 μm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete closure at 2 months and improvement in visual acuity.. The combination of topical dorzolamide and bevacizumab intravitreal injection is a reasonable consideration for small macular holes with vascular components before considering surgery. Both cases had early macular closure in less than 3 months.

Topics: Aged; Angiogenesis Inhibitors; Bevacizumab; Female; Humans; Intravitreal Injections; Retinal Perforations; Sulfonamides; Thiophenes; Tomography, Optical Coherence; Treatment Outcome

Hydration of retinal tissue has been proposed as a potential model of macular hole (MH) formation in addition to tractional forces of the vitreous and internal limiting membrane (ILM). Carbonic anhydrase inhibitors have previously been utilized in the treatment of cystoid macular edema in outer retinal diseases. There has been recent interest in the use of topical aqueous suppression as a potential medical therapy for MHs. In this case series, four eyes with small (< 300 μm) full-thickness MHs were treated with topical dorzolamide-timolol for 1 month. Two eyes achieved closure of the MH without surgical intervention, whereas the other two required pars plana vitrectomy with ILM peel. Future studies are required to investigate the role of topical aqueous suppression in the management of MHs. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e38-e43.].

Topics: Administration, Topical; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Female; Humans; Male; Middle Aged; Retinal Perforations; Sulfonamides; Thiophenes; Treatment Outcome