Current treatments for cystoid macular edema (CME) in retinitis pigmentosa (RP) are not always effective, may lead to adverse effects, and may not restore visual acuity. The present research lays the rationale for evaluating whether an iodine supplement could reduce CME in RP.
A study was orgnized at the Berman-Gund Laboratory for the Study of Retinal Degenerations, in the Department of Ophthalmology at Harvard Medical School, Massachusetts Eye and Ear Infirmary (MEEI) in Boston, to determine whether central foveal thickness (CFT) in the presence of CME is related to dietary iodine intake, which was inferred from urinary iodine concentration (UIC) in nonsmoking adults with RP.
This was a cross-sectional observational study of 212 nonsmoking patients between the ages of 18 to 69 years that were referred to MEEI for RP with visual acuity of no worse than 20/200 in at least 1 eye.
The study analyzed 199 patients after excluding 13 patients (11 who failed to return urine samples for measuring UIC and 2 outliers for UIC). Of the 199 patients, 36.2% had CME in 1 or both eyes. Although log CFT was inversely related to UIC based on findings from all eyes (P = .02), regression of log CFT on UIC separately for eyes with and without CME showed a strong inverse significant relationship for the former group (P < .001) and no significant relationship for the latter group (P = .66) as tested. For the eyes with CME, CFT ranged from a geometric mean of 267 µm for a median UIC of less than 100 µg/L to a geometric mean of 172 µm for a median UIC of 200 µg/L or greater. In contrast, the authors found no significant association between CME prevalence and UIC based on the entire sample as tested (odds ratio, 1.01 [95% CI, 0.38-2.67]; P = .99).
The study concludes that a higher UIC in nonsmoking adults with RP was significantly associated with less central foveal swelling in eyes with CME. The authors add that additional study is required to determine whether an iodine supplement can limit or reduce the extent of CME in patients with RP.
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