Efficacy for Sustained Use of Topical Dorzolamide for Treatment of Cystic Macular Lesions in Patients with X-Linked Retinoschisis (XLRS)

Objectives: To determine the efficacy for sustained use of topical 2% dorzolamide on visual acuity (VA) and macular cystic-appearing lesions in XLRS patients. Design: Retrospective analysis. Setting: University hospital tertiary care referral. Patients: Twenty nine eyes of 15 patients with XLRS on treatment with topical 2% dorzolamide for a duration ranged from 4-41 months were enrolled. Main Outcome Measures: Changes in VA, cystic macular lesions, and central foveal zone (CFZ) thickness on optical coherence tomography over a treatment duration follow-up (FU) period. Results: Among the 15 patients with XLRS, 20 eyes (68.9%) of 11 patients showed a positive response to treatment. Five of the 20 eyes (25.0%) in 3 of these 11 patients showed an initial response and a subsequent rebound of macular cysts. In 4 eyes (13.8%) of 3 patients, there was no response to treatment but the macular cysts did not worsen when compared to a baseline level. In five additional eyes (17.3%) of 4 patients, there was also no response to treatment and the macular cysts worsened when compared to a baseline level. Sixteen eyes (55.2%) of 12 patients had improvement in VA by ≥7 letters in at least one eye at the most recent FU visit. Seventeen eyes (58.6%) of 10 patients showed a reduction in the CFZ thickness in at least one eye when compared to the pretreatment level. Conclusion: In our cohort of XLRS patients, we observed that such patients have the potential to experience a beneficial effect from sustained treatment of 2% dorzolamide.