Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review

John D Sheppard1,2 1Virginia Eye Consultants, 2Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, US Abstract: Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, alone or in combination, have historically been used off label in the US to prevent and...

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Autor principal:	Sheppard JD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Anti-inflammatory agents nonsteroidal NSAID bromfenac cystoid macular edema Irvine-Gass syndrome Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5bc260cfa78e4aaead5935d2ffd2a3dd
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spelling	oai:doaj.org-article:5bc260cfa78e4aaead5935d2ffd2a3dd2021-12-02T06:10:58ZTopical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review1177-5483https://doaj.org/article/5bc260cfa78e4aaead5935d2ffd2a3dd2016-10-01T00:00:00Zhttps://www.dovepress.com/topical-bromfenac-for-prevention-and-treatment-of-cystoid-macular-edem-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483John D Sheppard1,2 1Virginia Eye Consultants, 2Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, US Abstract: Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, alone or in combination, have historically been used off label in the US to prevent and treat postoperative cystoid macular edema (CME). This literature review presents available data on the use of bromfenac 0.07% or 0.09% to prevent and treat CME following cataract surgery. Bromfenac is an NSAID approved to treat postoperative inflammation and reduce ocular pain following cataract surgery. Few cases of clinical CME were observed with bromfenac use in a total of 19 reviewed studies. There were no significant differences in CME incidence between bromfenac and corticosteroid-treated patients or between bromfenac- and bromfenac plus corticosteroid-treated patients. Bromfenac demonstrated comparable efficacy to other NSAIDs in preventing CME. Compared with corticosteroids, bromfenac alone or plus a corticosteroid showed similar or better efficacy in minimizing changes in retinal thickness and macular volume. In diabetic cataract surgery patients, bromfenac was comparable or superior to corticosteroids for minimizing changes in retinal thickness; also, combination therapy with bromfenac and corticosteroids may be associated with smaller changes in foveal thickness, macular thickness, and macular volume versus monotherapy with either treatment alone in this patient population. In two randomized, double-masked, placebo-controlled clinical trials with bromfenac 0.07%, CME was reported as an adverse event in 0.5% and 1.5% of patients receiving bromfenac and placebo, respectively. In an analysis of four placebo-controlled trials with bromfenac 0.09%, macular edema was reported in 0.7% and 1.4% of patients receiving bromfenac and placebo, respectively. When evaluated as treatment for acute or chronic CME, bromfenac was associated with improvement in visual acuity and reduction in retinal thickness, but few studies are available. Overall, published data suggest that bromfenac is safe and effective when used to prevent or treat CME. Large-scale placebo-controlled trials and greater standardization of CME measures are needed to establish optimal bromfenac regimens for the prophylaxis and treatment of CME following cataract surgery. Keywords: anti-inflammatory agents, nonsteroidal, NSAID, bromfenac, cystoid macular edema, Irvine–Gass syndromeSheppard JDDove Medical PressarticleAnti-inflammatory agentsnonsteroidalNSAIDbromfenaccystoid macular edemaIrvine-Gass syndromeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 2099-2111 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anti-inflammatory agents nonsteroidal NSAID bromfenac cystoid macular edema Irvine-Gass syndrome Ophthalmology RE1-994
spellingShingle	Anti-inflammatory agents nonsteroidal NSAID bromfenac cystoid macular edema Irvine-Gass syndrome Ophthalmology RE1-994 Sheppard JD Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
description	John D Sheppard1,2 1Virginia Eye Consultants, 2Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, US Abstract: Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, alone or in combination, have historically been used off label in the US to prevent and treat postoperative cystoid macular edema (CME). This literature review presents available data on the use of bromfenac 0.07% or 0.09% to prevent and treat CME following cataract surgery. Bromfenac is an NSAID approved to treat postoperative inflammation and reduce ocular pain following cataract surgery. Few cases of clinical CME were observed with bromfenac use in a total of 19 reviewed studies. There were no significant differences in CME incidence between bromfenac and corticosteroid-treated patients or between bromfenac- and bromfenac plus corticosteroid-treated patients. Bromfenac demonstrated comparable efficacy to other NSAIDs in preventing CME. Compared with corticosteroids, bromfenac alone or plus a corticosteroid showed similar or better efficacy in minimizing changes in retinal thickness and macular volume. In diabetic cataract surgery patients, bromfenac was comparable or superior to corticosteroids for minimizing changes in retinal thickness; also, combination therapy with bromfenac and corticosteroids may be associated with smaller changes in foveal thickness, macular thickness, and macular volume versus monotherapy with either treatment alone in this patient population. In two randomized, double-masked, placebo-controlled clinical trials with bromfenac 0.07%, CME was reported as an adverse event in 0.5% and 1.5% of patients receiving bromfenac and placebo, respectively. In an analysis of four placebo-controlled trials with bromfenac 0.09%, macular edema was reported in 0.7% and 1.4% of patients receiving bromfenac and placebo, respectively. When evaluated as treatment for acute or chronic CME, bromfenac was associated with improvement in visual acuity and reduction in retinal thickness, but few studies are available. Overall, published data suggest that bromfenac is safe and effective when used to prevent or treat CME. Large-scale placebo-controlled trials and greater standardization of CME measures are needed to establish optimal bromfenac regimens for the prophylaxis and treatment of CME following cataract surgery. Keywords: anti-inflammatory agents, nonsteroidal, NSAID, bromfenac, cystoid macular edema, Irvine–Gass syndrome
format	article
author	Sheppard JD
author_facet	Sheppard JD
author_sort	Sheppard JD
title	Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
title_short	Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
title_full	Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
title_fullStr	Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
title_full_unstemmed	Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
title_sort	topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/5bc260cfa78e4aaead5935d2ffd2a3dd
work_keys_str_mv	AT sheppardjd topicalbromfenacforpreventionandtreatmentofcystoidmacularedemafollowingcataractsurgeryareview
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Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review

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