A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis

S. M. Whitcup, K. G. Csaky, M. J. Podgor, E. Y. Chew, C. H. Perry, R. B. Nussenblatt, Janet L Davis

Research output: Contribution to journalArticle

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Abstract

Purpose: To study the effect of acetazolamide on cystoid macular edema in patients with uveitis. Methods: Forty patients with chronic intermediate, posterior, or panuveitis associated cystoid macular edema were randomized into a masked, cross-over trial comparing acetazolamide versus placebo. Patients received an initial 4-week course of either acetazolamide or placebo (course A) followed by a 4-week washout period. They then received a 4-week course of the opposite study medication (course B). Primary endpoints included area of cystoid macular edema measured on late-phase views of fluorescein angiography and visual acuity. Results: Thirty-seven patients completed the trial and were available for analysis; 17 (46%) were randomized to receive acetazolamide and 20 (54%) to receive placebo during course A. Acetazolamide resulted in a 0.5-disc area (25%) decrease in cystoid macular edema over that of placebo (P = 0.01; estimated treatment effect = -0.5 disc areas; 95% confidence interval, -0.9 to -0.1). However, there was no statistically significant effect of acetazolamide on visual acuity (P = 0.61; estimated treatment effect = 0.6 letters; 95% confidence interval, -2 to 3). Conclusions: A 4-week course of acetazolamide therapy results in a statistically significant but small decrease in cystoid macular edema in patients with chronic uveitis, and does not improve visual acuity. In contrast to previous studies in the literature, acetazolamide may have a more limited clinical benefit in patients with long-standing cystoid macular edema associated with chronic uveitis.

Original languageEnglish
Pages (from-to)1054-1063
Number of pages10
JournalOphthalmology
Volume103
Issue number7
StatePublished - Aug 10 1996
Externally publishedYes

Fingerprint

Acetazolamide
Macular Edema
Uveitis
Cross-Over Studies
Placebos
Visual Acuity
Panuveitis
Confidence Intervals
Fluorescein Angiography
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Whitcup, S. M., Csaky, K. G., Podgor, M. J., Chew, E. Y., Perry, C. H., Nussenblatt, R. B., & Davis, J. L. (1996). A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis. Ophthalmology, 103(7), 1054-1063.

A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis. / Whitcup, S. M.; Csaky, K. G.; Podgor, M. J.; Chew, E. Y.; Perry, C. H.; Nussenblatt, R. B.; Davis, Janet L.

In: Ophthalmology, Vol. 103, No. 7, 10.08.1996, p. 1054-1063.

Research output: Contribution to journalArticle

Whitcup, SM, Csaky, KG, Podgor, MJ, Chew, EY, Perry, CH, Nussenblatt, RB & Davis, JL 1996, 'A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis', Ophthalmology, vol. 103, no. 7, pp. 1054-1063.
Whitcup SM, Csaky KG, Podgor MJ, Chew EY, Perry CH, Nussenblatt RB et al. A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis. Ophthalmology. 1996 Aug 10;103(7):1054-1063.
Whitcup, S. M. ; Csaky, K. G. ; Podgor, M. J. ; Chew, E. Y. ; Perry, C. H. ; Nussenblatt, R. B. ; Davis, Janet L. / A randomized, masked, crossover trial of acetazolamide for cystoid macular edema in patients with uveitis. In: Ophthalmology. 1996 ; Vol. 103, No. 7. pp. 1054-1063.
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abstract = "Purpose: To study the effect of acetazolamide on cystoid macular edema in patients with uveitis. Methods: Forty patients with chronic intermediate, posterior, or panuveitis associated cystoid macular edema were randomized into a masked, cross-over trial comparing acetazolamide versus placebo. Patients received an initial 4-week course of either acetazolamide or placebo (course A) followed by a 4-week washout period. They then received a 4-week course of the opposite study medication (course B). Primary endpoints included area of cystoid macular edema measured on late-phase views of fluorescein angiography and visual acuity. Results: Thirty-seven patients completed the trial and were available for analysis; 17 (46{\%}) were randomized to receive acetazolamide and 20 (54{\%}) to receive placebo during course A. Acetazolamide resulted in a 0.5-disc area (25{\%}) decrease in cystoid macular edema over that of placebo (P = 0.01; estimated treatment effect = -0.5 disc areas; 95{\%} confidence interval, -0.9 to -0.1). However, there was no statistically significant effect of acetazolamide on visual acuity (P = 0.61; estimated treatment effect = 0.6 letters; 95{\%} confidence interval, -2 to 3). Conclusions: A 4-week course of acetazolamide therapy results in a statistically significant but small decrease in cystoid macular edema in patients with chronic uveitis, and does not improve visual acuity. In contrast to previous studies in the literature, acetazolamide may have a more limited clinical benefit in patients with long-standing cystoid macular edema associated with chronic uveitis.",
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AU - Perry, C. H.

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N2 - Purpose: To study the effect of acetazolamide on cystoid macular edema in patients with uveitis. Methods: Forty patients with chronic intermediate, posterior, or panuveitis associated cystoid macular edema were randomized into a masked, cross-over trial comparing acetazolamide versus placebo. Patients received an initial 4-week course of either acetazolamide or placebo (course A) followed by a 4-week washout period. They then received a 4-week course of the opposite study medication (course B). Primary endpoints included area of cystoid macular edema measured on late-phase views of fluorescein angiography and visual acuity. Results: Thirty-seven patients completed the trial and were available for analysis; 17 (46%) were randomized to receive acetazolamide and 20 (54%) to receive placebo during course A. Acetazolamide resulted in a 0.5-disc area (25%) decrease in cystoid macular edema over that of placebo (P = 0.01; estimated treatment effect = -0.5 disc areas; 95% confidence interval, -0.9 to -0.1). However, there was no statistically significant effect of acetazolamide on visual acuity (P = 0.61; estimated treatment effect = 0.6 letters; 95% confidence interval, -2 to 3). Conclusions: A 4-week course of acetazolamide therapy results in a statistically significant but small decrease in cystoid macular edema in patients with chronic uveitis, and does not improve visual acuity. In contrast to previous studies in the literature, acetazolamide may have a more limited clinical benefit in patients with long-standing cystoid macular edema associated with chronic uveitis.

AB - Purpose: To study the effect of acetazolamide on cystoid macular edema in patients with uveitis. Methods: Forty patients with chronic intermediate, posterior, or panuveitis associated cystoid macular edema were randomized into a masked, cross-over trial comparing acetazolamide versus placebo. Patients received an initial 4-week course of either acetazolamide or placebo (course A) followed by a 4-week washout period. They then received a 4-week course of the opposite study medication (course B). Primary endpoints included area of cystoid macular edema measured on late-phase views of fluorescein angiography and visual acuity. Results: Thirty-seven patients completed the trial and were available for analysis; 17 (46%) were randomized to receive acetazolamide and 20 (54%) to receive placebo during course A. Acetazolamide resulted in a 0.5-disc area (25%) decrease in cystoid macular edema over that of placebo (P = 0.01; estimated treatment effect = -0.5 disc areas; 95% confidence interval, -0.9 to -0.1). However, there was no statistically significant effect of acetazolamide on visual acuity (P = 0.61; estimated treatment effect = 0.6 letters; 95% confidence interval, -2 to 3). Conclusions: A 4-week course of acetazolamide therapy results in a statistically significant but small decrease in cystoid macular edema in patients with chronic uveitis, and does not improve visual acuity. In contrast to previous studies in the literature, acetazolamide may have a more limited clinical benefit in patients with long-standing cystoid macular edema associated with chronic uveitis.

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