BMJ Open Ophthalmology (Aug 2024)

Somatostatin analogues as a treatment option for cystoid maculopathy in retinitis pigmentosa

  • P Martin van Hagen,
  • L Ingeborgh van den Born,
  • Caroline C W Klaver,
  • Alberta A H J Thiadens,
  • Pam A T Heutinck,
  • Jan A M van Laar,
  • Dzenita Smailhodzic,
  • Magda A Meester-Smoor,
  • Virginie J M Verhoeven

DOI
https://doi.org/10.1136/bmjophth-2024-001722
Journal volume & issue
Vol. 9, no. 1

Abstract

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Aims This study aimed to evaluate the effectiveness of somatostatin analogues (SA) for cystoid maculopathy (CM) in retinitis pigmentosa (RP) patients.Materials and methods In this retrospective case series, clinical and imaging characteristics of 28 RP patients with CM, unresponsive to carbonic anhydrase inhibitors, were collected from medical charts. All patients received SA treatment as an alternative (octreotide long-acting release at 20 mg/month or 30 mg/month, or lanreotide at 90 mg/month or 120 mg/month). Outcome measures were mean reduction in foveal thickness (FT) and foveal volume (FV) and mean increase in best-corrected visual acuity at 3, 6 and 12 months of treatment initiation. Linear mixed models were used to calculate the effectiveness over time.Results 52 eyes of 28 RP patients were included; 39% were male. The median age at the start of treatment was 39 years (IQR 30–53). Median follow-up was 12 months (range 6–12). From baseline to 12 months, the mean FT decreased from 409±136 µm to 334±119 µm and the mean FV decreased from 0.31±0.10 mm3 to 0.25±0.04 mm3. Linear mixed model analyses showed a significant decrease in log FT and log FV at 3, 6 and 12 months after the start of treatment compared with baseline measurements (p<0.001, p<0.001, p<0.001). Mean best-corrected visual acuity did not increase significantly (0.46±0.35 logMAR to 0.45±0.38 logMAR after 12 months).Discussion SA may be an effective alternative treatment to reduce CM in RP patients.