Acetazolamide for Cystoid Macular Oedema in Bietti Crystalline Retinal Dystrophy
A 32-year-old male of Maltese heritage who was known to have electroretinogram-confirmed Bietti crystalline retinal dystrophy presented with acute bilateral central visual impairment. Upon examination, best-corrected visual acuity (BCVA) was 6 / 60 in the right eye and 6 / 45 in the left eye. At an examination one year previously, BCVA had been 6 / 7.5 in the right eye and 6 / 18 in the left.\nDilated retinal examination revealed the presence of peripheral corneal and retina crystalline changes characteristic of Bietti dystrophy (). Flourescein angiography showed patchy hypof luorescence indicative of chorioretinal atrophy. No evidence of late leakage was observed, excluding the diagnosis of choroidal neovascularisation (). Time-domain (TD)-OCT was performed and demonstrated bilateral cystic macular lesions () with a central foveal thickness (CFT) of 242 µm in the right eye and 253 µm in the left.\nOn the basis of the OCT findings, the patient was diagnosed with cystoid macular oedema. Acetazolamide therapy at a dose of 500 mg daily was initiated, and one month later, visual acuity improved to 6 / 18 bilaterally and CFT reduced to 221 µm in the right eye and 225 µm in the left eye. Following one year of acetazolamide therapy, BCVA was 6 / 15 in the right eye and 6 / 24 in the left eye, and CFT had stabilised at 221 µm in the right eye and 219 µm in the left eye ().