Therapeutic Efficacy of Spironolactone for Central Serous Chorioretinopathy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy(CSC). Materials and Methods: The medical records and imaging data of patients diagnosed with CSC and treated with SPRL were retrospectivelyreviewed. Central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), andbest-corrected visual acuity (BCVA) at baseline, at 1, 3, and 6 months, and at the last visit after the treatment were analyzed. Results: In total, 103 patients with 107 eyes were included. The mean age of the patients was 51.5±9.3 years, and 77 (72.0%) weremale. The mean follow-up duration was 48.6±40.2 weeks. The mean duration of oral SPRL therapy was 15.5±13.4 weeks. CMT, SRFheight, and SFCT improved significantly at 1, 3, and 6 months after SPRL therapy and at the last follow-up. BCVA, however, showedno significant change at any time point. The rate of complete resolution of SRF at 1 month was higher in those with chronic CSCthan in those with acute CSC (21.1% vs. 6.0%, respectively). Recurrence occurred in 14 (13.1%) eyes after the complete resolution ofSRF. Older age (p=0.001), a greater number of previous intravitreal bevacizumab injections (p=0.006), and poor initial visual acuity(p=0.048) were associated with recurrence. No permanent adverse effects were observed. Conclusion: Oral SPRL showed therapeutic benefits in patients with CSC in terms of SRF resolution, but relatively frequent recurrencewas observed, especially in older patients.
Abstract
Purpose: To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy(CSC). Materials and Methods: The medical records and imaging data of patients diagnosed with CSC and treated with SPRL were retrospectivelyreviewed. Central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), andbest-corrected visual acuity (BCVA) at baseline, at 1, 3, and 6 months, and at the last visit after the treatment were analyzed. Results: In total, 103 patients with 107 eyes were included. The mean age of the patients was 51.5±9.3 years, and 77 (72.0%) weremale. The mean follow-up duration was 48.6±40.2 weeks. The mean duration of oral SPRL therapy was 15.5±13.4 weeks. CMT, SRFheight, and SFCT improved significantly at 1, 3, and 6 months after SPRL therapy and at the last follow-up. BCVA, however, showedno significant change at any time point. The rate of complete resolution of SRF at 1 month was higher in those with chronic CSCthan in those with acute CSC (21.1% vs. 6.0%, respectively). Recurrence occurred in 14 (13.1%) eyes after the complete resolution ofSRF. Older age (p=0.001), a greater number of previous intravitreal bevacizumab injections (p=0.006), and poor initial visual acuity(p=0.048) were associated with recurrence. No permanent adverse effects were observed. Conclusion: Oral SPRL showed therapeutic benefits in patients with CSC in terms of SRF resolution, but relatively frequent recurrencewas observed, especially in older patients.
참고문헌 (32)
- Kitzmann AS, "The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980-2002", Ophthalmology, 115, pp.169~173 (2008)
- Imamura Y, "Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy", Retina, 29, pp.1469~1473 (2009)
- Spaide RF, "Indocyanine green videoangiography of older patients with central serous chorioretinopathy", Retina, 16, pp.203~213 (1996)
- Daruich A, "Acute central serous chorioretinopathy : factors influencing episode duration", Retina, 37, pp.1905~1915 (2017)
- Gilbert CM, "Long-term follow-up of central serous chorioretinopathy", Br J Ophthalmol, 68, pp.815~820 (1984)
- Nicholson B, "Central serous chorioretinopathy : update on pathophysiology and treatment", Surv Ophthalmol, 58, pp.103~126 (2013)
- Yannuzzi LA, "Type A behavior and central serous chorioretinopathy", Trans Am Ophthalmol Soc, 84, pp.799~845 (1986)
- Pikkel J, "Acetazolamide for central serous retinopathy", Ophthalmology, 109, pp.1723~1725 (2002)
- Burumcek E, "Laser photocoagulation for persistent central serous retinopathy : results of longterm follow-up", Ophthalmology, 104, pp.616~622 (1997)
- Beger I, "Treatment of central serous chorioretinopathy:MicroPulse photocoagulation versus bevacizumab", Ophthalmologe, 109, pp.1224~1232 (2012)
- Kim GA, "Clinical characteristics of responders to intravitreal bevacizumab in central serous chorioretinopathy patients", Eye(Lond), 29, pp.732~740 (2015)
- Roisman L, "Micropulse diode laser treatment for chronic central serous chorioretinopathy : a randomized pilot trial", Ophthalmic Surg Lasers Imaging Retina, 44, pp.465~470 (2013)
- Chan WM, "Safety enhanced photodynamic therapy for chronic central serous chorioretinopathy : one-year results of a prospective study", Retina, 28, pp.85~93 (2008)
- Nicoló M, "Half-fluence versus half-dose photodynamic therapy in chronic central serous chorioretinopathy", Am J Ophthalmol, 157, pp.1033~1037 (2014)
- Park W, "Comparing effects of photodynamic therapy in central serous chorioretinopathy : full-dose versus half-dose versus half-dose-half-fluence", Graefes Arch Clin Exp Ophthalmol, 257, pp.2155~2161 (2019)
- Bousquet E, "Spironolactone for nonresolving central serous chorioretinopathy : a randomized controlled crossover study", Retina, 35, pp.2505~2515 (2015)
- Bousquet E, "Predictive factors of response to mineralocorticoid receptor antagonists in nonresolving central serous chorioretinopathy", Am J Ophthalmol, 198, pp.80~87 (2019)
- Cakir B, "Clinical experience with eplerenone to treat chronic central serous chorioretinopathy", Graefes Arch Clin Exp Ophthalmol, 254, pp.2151~2157 (2016)
- Ghadiali Q, "Central serous chorioretinopathy treated with mineralocorticoid antagonists : a one-year pilot study", Retina, 36, pp.611~618 (2016)
- Lee JH, "Comparison of short-term efficacy between oral spironolactone treatment and photodynamic therapy for the treatment of nonresolving central serous chorioretinopathy", Retina, 39, pp.127~133 (2019)
- Zhao M, "Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy", J Clin Invest, 122, pp.2672~2679 (2012)
- Daruich A, "Oral mineralocorticoid-receptor antagonists : real-life experience in clinical subtypes of nonresolving central serous chorioretinopathy with chronic epitheliopathy", Transl Vis Sci Technol, 5, pp.2~ (2016)
- Rahimy E, "A randomized double-blind placebo-control pilot study of eplerenone for the treatment of central serous chorioretinopathy(ecselsior)", Retina, 38, pp.962~969 (2018)
- Sun X, "Spironolactone versus observation in the treatment of acute central serous chorioretinopathy", Br J Ophthalmol, 102, pp.1060~1065 (2018)
- Lotery A, "Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4months(VICI) : a randomised, double-blind, placebo-controlled trial", Lancet, 395, pp.294~303 (2020)
- Fujita K, "One-year outcomes with half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy", Ophthalmology, 122, pp.555~561 (2015)
- Inoue R, "Association between the efficacy of photodynamic therapy and indocyanine green angiography findings for central serous chorioretinopathy", Am J Ophthalmol, 149, pp.441~446.e1-2 (2010)
- Fusi-Rubiano W, "Oral medications for central serous chorioretinopathy: a literature review", Eye (Lond), 34, pp.809~824 (2020)
- Herold TR, "Long-term results and recurrence rates after spironolactone treatment in nonresolving central serous chorio-retinopathy(CSCR)", Graefes Arch Clin Exp Ophthalmol, 255, pp.221~229 (2017)
- Cardillo Piccolino F, "Photodynamic therapy for chronic central serous chorioretinopathy", Retina, 23, pp.752~763 (2003)
- Yannuzzi LA, "Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy : a pilot study", Retina, 23, pp.288~298 (2003)
- Levy LL, "Female pattern alopecia : current perspectives", Int J Womens Health, 5, pp.541~556 (2013)