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Objectives:

To evaluate the efficacy of topical nepafenac in patients with impaired blood-retinal barrier (BRB) in the macular area.

Methods:

In a prospective pilot study 15 eyes were included; in the first visit and controls complete eye examination was performed (mean follow-up: 79 days). Visual acuity (VA), central thickness (CT) and macular volume (MV) were evaluated. All patients (mean age: 72.7 years) were analyzed before and after the treatment, and then sub – analysis of two groups was made: A) with diffuse diabetic macular edema – DDME and B) with Irvine – Gass syndrome.

Results:

Patients had an initial VA (Snellen) of 0.40 with a final improvement of 0.46 (p = 0.026), the CT was reduced from 394.92 to 292 microns (p = 0.002) and MV showed a global decrease of 11.26 to 10.65 mm3 (p = 0.013). Analyzed sub-parameters of group A (DDME) show that, except in the VA (p = 0.08), the difference was significant in reduction of CT (p = 0.01) and MV (p = 0.05). Patients with post-surgical macular edema (group B) had statistically significant differences in VA (p = 0.02) and the central thickness (p = 0.03) but not in the MV (p = 0.17).

Conclusions:

In our study, nepafenac has proven to be clinically safe and effective treatment, capable of stabilizing the BRB and thereby, reduce macular edema and restore vision. The obtained visual benefit was better in patients with Irvine – Gass syndrome than with DDME.