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螺内酯治疗前后近视患者中与穹窿状黄斑和葡萄肿边缘相关的浆液性视网膜脱离

Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone.

作者信息

Fernández-Vega Sanz Álvaro, Rangel Carlos Mario, Villota Deleu Eva, Fernández-Vega Sanz Beatriz, Sánchez-Ávila Ronald Mauricio

机构信息

Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain; Instituto Universitario Fernández-Vega, Universidad de Oviedo, Oviedo, Spain.

Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain; Fundación Oftalmológica de Santander (FOSCAL), Floridablanca 681004, Colombia; Universidad Industrial de Santander, Bucaramanga 680002, Colombia.

出版信息

J Ophthalmol. 2016;2016:8491320. doi: 10.1155/2016/8491320. Epub 2016 Jan 28.

Abstract

Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P = 0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P = 0.010). There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

摘要

目的。浆液性视网膜脱离(SRD)是近视患者中与黄斑圆顶(DSM)和葡萄肿边缘相关的常见解剖学并发症。在此,我们描述了使用盐皮质激素拮抗剂口服螺内酯治疗伴有DSM和葡萄肿边缘的近视性SRD患者所获得的解剖学和功能结果。方法。我们评估了12例患有与DSM或葡萄肿边缘相关的长期SRD的近视患者的双眼。患者每天口服50毫克螺内酯,持续治疗6个月。在第一天和每月的随访中,通过光学相干断层扫描测定最佳矫正视力(BCVA)和中心视网膜厚度(CRT)。结果。治疗前BCVA(平均值±标准差)为0.406±0.324 LogMAR,治疗后BCVA为0.421±0.354 LogMAR(P = 0.489)。治疗前CRT为323.9±78.6μm,治疗6个月后显著降低,为291.2±74.5μm(P = 0.010)。没有与治疗相关的并发症。结论。我们评估了一种治疗近视患者中与DSM和葡萄肿边缘相关的SRD的新方法。用盐皮质激素拮抗剂螺内酯治疗6个月后,视网膜下液和CRT显著减少;然而,BCVA没有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c22/4749819/e7eb12effcca/JOPH2016-8491320.001.jpg

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