Vitreoretinal surgery for cystoid macular edema associated with retinitis pigmentosa

Purpose: To evaluate the anatomic and functional outcome of vitreoretinal surgery in eyes with retinitis pigmentosa (RP) and macular edema. Design: Prospective noncomparative case series. Participants: Twelve consecutive eyes of eight patients with RP and a documented decrease in visual acuity (VA) to 20/60 or worse caused by macular edema refractory to medical therapy. Methods: Pars plana vitrectomy was performed in the 12 eyes, followed by posterior hyaloid dissection, removal of the posterior inner limiting membrane after staining with indocyanine green, and gas tamponade. Preoperative best-corrected VAs ranged from 20/60 to 20/400 (mean, 20/115). Main Outcome Measures: Changes in VA and foveal thickness as determined by optical coherence tomography (OCT). Results: The mean preoperative retinal thickness at the fovea was 477 mum. Optical coherence tomography showed a decrease in macular thickness of >40% in 10 eyes (83.3%), with a mean postoperative foveal thickness of 260 mum. The mean VA increased from 20/115 to 20/45, with an average of three lines of improvement. Conclusions: Our results suggest that vitreoretinal surgery may effectively manage macular edema in RP. (C) 2003 by the American Academy of Ophthalmology.