螺内酯治疗非消退型中心性浆液性脉络膜视网膜病变：一项随机对照交叉研究

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核心技术专利：CN118964589B侵权必究

Suppr 超能文献

核心技术专利：CN118964589B侵权必究

Bousquet Elodie, Beydoun Talal, Rothschild Pierre-Raphaël, Bergin Ciara, Zhao Min, Batista Rui, Brandely Marie-Laure, Couraud Benedicte, Farman Nicolette, Gaudric Alain, Chast François, Behar-Cohen Francine

*Department of Ophthalmology, Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Paris, France, Université Sorbonne Paris Cité; †Inserm U1138, Team 17, Université Sorbonne Paris Cité, Université Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France; ‡Department of Ophthalmology, University of Lausanne, Jules Gonin Ophthalmic Hospital, Fondation Asile des aveugles, Switzerland; §Department of Pharmacy Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Université Sorbonne Paris Cité, Paris, France; ¶INSERM, U1138, Team 1, Université René Descartes Sorbonne Paris Cité, Université Pierre et Marie Curie Paris, Centre de Recherche des Cordeliers, Paris, France; and **Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Université Paris Diderot, Paris, France.

Retina. 2015 Dec;35(12):2505-15. doi: 10.1097/IAE.0000000000000614.

PURPOSE: To evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, for nonresolving central serous chorioretinopathy. METHODS: This is a prospective, randomized, double-blinded, placebo-controlled crossover study. Sixteen eyes of 16 patients with central serous chorioretinopathy and persistent subretinal fluid (SRF) for at least 3 months were enrolled. Patients were randomized to receive either spironolactone 50 mg or placebo once a day for 30 days, followed by a washout period of 1 week and then crossed over to either placebo or spironolactone for another 30 days. The primary outcome measure was the changes from baseline in SRF thickness at the apex of the serous retinal detachment. Secondary outcomes included subfoveal choroidal thickness and the ETDRS best-corrected visual acuity. RESULTS: The mean duration of central serous chorioretinopathy before enrollment in study eyes was 10 ± 16.9 months. Crossover data analysis showed a statistically significant reduction in SRF in spironolactone treated eyes as compared with the same eyes under placebo (P = 0.04). Secondary analysis on the first period (Day 0-Day 30) showed a significant reduction in subfoveal choroidal thickness in treated eyes as compared with placebo (P = 0.02). No significant changes were observed in the best-corrected visual acuity. There were no complications related to treatment observed. CONCLUSION: In eyes with persistent SRF due to central serous chorioretinopathy, spironolactone significantly reduced both the SRF and the subfoveal choroidal thickness as compared with placebo.

目的：评估盐皮质激素受体拮抗剂螺内酯对不消退的中心性浆液性脉络膜视网膜病变的疗效。方法：这是一项前瞻性、随机、双盲、安慰剂对照的交叉研究。纳入16例中心性浆液性脉络膜视网膜病变且视网膜下液（SRF）持续至少3个月的患者的16只眼。患者被随机分为两组，一组每天服用50mg螺内酯，另一组服用安慰剂，为期30天，随后有1周的洗脱期，然后交叉接受另一组治疗，为期30天。主要观察指标是浆液性视网膜脱离顶点处SRF厚度相对于基线的变化。次要观察指标包括黄斑中心凹下脉络膜厚度和ETDRS最佳矫正视力。结果：研究眼入组前中心性浆液性脉络膜视网膜病变的平均病程为10±16.9个月。交叉数据分析显示，与服用安慰剂时相比，螺内酯治疗眼的SRF有统计学意义的降低（P = 0.04）。对第一阶段（第0天至第30天）的次要分析显示，与安慰剂相比，治疗眼的黄斑中心凹下脉络膜厚度有显著降低（P = 0.02）。最佳矫正视力未观察到显著变化。未观察到与治疗相关的并发症。结论：对于因中心性浆液性脉络膜视网膜病变导致持续性SRF的眼，与安慰剂相比，螺内酯可显著降低SRF和黄斑中心凹下脉络膜厚度。