In patients with retinitis pigmentosa–associated cystoid macular edema that is refractory to medical management, does pars plana vitrectomy have a therapeutic role?  

Patients with RP have an increased incidence of macular edema (CME) and epiretinal membranes (ERM). If CME is associated with ERM, then there may be a role of PPV with membrane peel, but if CME is isolated, oral or topical carbonic anhydrase inhibitors would be considered the treatment of choice.

My experience is that typically, CME does not cause too much central vision loss. Pars plana vitrectomy can possibly be done in refractory CME secondary to RP but the risk-benefit ratio has to be ascertained in individual patients. In some patients, the visual acuity may be reduced due to atrophic f...