Topical nepafenac as an alternate treatment for cystoid macular edema in steroid responsive patients

Abstract

Purpose: 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.

Conclusion: Nepafenac may be an effective and safe therapy for treating chronic cystoid macular edema in patients who are steroid responders.