Complex Method of Treatment of Macular Interface Pathology in a Patient with Retinitis Pigmentosa

Relevance. Evaluate the effect of surgical treatment of epiretinal fibrosis and postoperative drug therapy on visual functions in a patient with retinitis pigmentosa.
Purpose. Patient K., 56 y.o., applied to the Moscow City Ophthalmological Center, S.P. Botkin Hospital with complaints of a decrease vision, distortion of straight lines in the left eye, floating opacities in both eyes. For 15 years, the patient notes that she sees worse at night and in rooms with little lighting. According to the results of the examination, the diagnosis was established: OU Epiretinal fibrosis, Synchysis Scintillans, retinitis pigmentosa, initial cataract. Due to the presence of specific complaints in the left eye, optical coherence tomography data, and low visual acuity (0.2), the patient underwent surgery: OS Microinvasive subtotal vitrectomy + epiretinal membrane removal + tamponade of the vitreal cavity.
Results. On the next day, there was a decrease in metamorphopsies and an increase in visual acuity to 0.5. One week after surgery, there was a decrease in visual acuity in the operated eye to 0.4, an increase in the number of metamorphopsies and the development of the clinical picture of cystic macular edema. Combined postoperative conservative therapy, which included the installation use of a glucocorticosteroid, a nonsteroidal anti-inflammatory drug and a carbonic anhydrase inhibitor, allowed to achieve a decrease in macular edema and an increase in visual acuity to 0.8.
Conclusion. Surgical treatment of epiretinal fibrosis in combination with postoperative conservative therapy, including a carbonic anhydrase inhibitor and a nonsteroidal anti-inflammatory drug, in patients with retinitis pigmentosa can lead to an improvement in the anatomical picture of the macular profile and an increase in visual acuity.

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