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Intraocular pressure response to acetazolamide in patients with retinal detachment
Author(s) -
ARNDT C,
DUCASSE A,
GHOUALI W
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.s062.x
Subject(s) - acetazolamide , intraocular pressure , carbonic anhydrase inhibitor , ophthalmology , medicine , retinal , carbonic anhydrase , retinal detachment , anesthesia , chemistry , biochemistry , enzyme
Purpose Besides the responsibility of vitreous traction, deficient photoreceptors adherence due to lower fluid transport of the retinal pigment epithelium (RPE) has been hypothezised to be involved in the occurrence of retinal detachment(RD). However this adherence remains difficult to evaluate in patients. Acetazolamide reduces aqueous secretion of the ciliairy body and stimulates fluid absorption by the RPE. Recording the intraocular pressure response to systemic acetazolamide could enable to indirectly evaluate the carbonic anhydrase activity of the RPE. Methods The response to intraveineous acetazolamide was evaluated on the first postoperative day in 30 patients undergoing either RD surgery (n=15) or epiretinal membrane peeling (n=15). Intraocular pressure was measured with a handheld Perkins tonometer in suppine position before (t‐2 min) and after the administration of acetazolamide (t+2 min,t+6min ,t+10 min and t+30 min). The mean variation of the intraocular pressure was compared between the two groups. Results Consecutively to the intraveineous injection of acetazolamide, a reduction of the intraocular pressure was observed in both groups (both n=15). This reduction was significantly lower in the group of patients who underwent RD surgery. The observed difference remained significant until 10 minutes (p<0,01 at t= 2, 6 and 10 min). At t=30 min, the intraocular pressure reduction was comparable in both groups. Conclusion The response to acetazolamide is significantly lower in patients undergoing RD surgery. Further research should aim to confirm the value of the intraocular pressure response to acetazolamide for characterizing photoreceptor adherence.