Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Siloam Eye Hospital, Seoul, Korea.
Retina. 2019 Jan;39(1):127-133. doi: 10.1097/IAE.0000000000001913.
To compare the short-term therapeutic efficacy of oral spironolactone treatment with that of half-dose photodynamic therapy (PDT) in patients with nonresolving central serous chorioretinopathy.
This retrospective, interventional, comparative study included 41 patients with nonresolving central serous chorioretinopathy who exhibited subretinal fluid accumulation for more than 3 months. Of the 41 patients, 18 (18 eyes) received oral spironolactone treatment and 23 (23 eyes) received half-dose PDT. Treatment outcomes, including the central macular thickness, subretinal fluid height, subfoveal choroidal thickness, and best-corrected visual acuity, were measured at baseline and 1 and 3 months after treatment.
There were no differences in baseline characteristics between the two groups. The central macular thickness and the subretinal fluid height significantly decreased at 1 and 3 months after treatment. The central macular thickness at 1 month was lesser in the PDT group than in the spironolactone group. The subfoveal choroidal thickness decreased at 1 and 3 months only in the PDT group, whereas best-corrected visual acuity showed a significant improvement at 3 months in both groups.
Our results suggest that the short-term efficacy of oral spironolactone treatment for the management of nonresolving central serous chorioretinopathy is comparable with that of half-dose PDT, with an excellent safety profile.
比较口服螺内酯治疗与半剂量光动力疗法(PDT)治疗未缓解性中心性浆液性脉络膜视网膜病变的短期疗效。
本回顾性、干预性、对照研究纳入了 41 例存在视网膜下积液超过 3 个月的未缓解性中心性浆液性脉络膜视网膜病变患者。其中 18 例(18 只眼)接受口服螺内酯治疗,23 例(23 只眼)接受半剂量 PDT。在基线和治疗后 1 个月和 3 个月时测量治疗结局,包括中央黄斑厚度、视网膜下积液高度、中心凹下脉络膜厚度和最佳矫正视力。
两组患者的基线特征无差异。治疗后 1 个月和 3 个月时中央黄斑厚度和视网膜下积液高度均显著降低。PDT 组治疗后 1 个月时中央黄斑厚度低于螺内酯组。仅在 PDT 组中,中心凹下脉络膜厚度在治疗后 1 个月和 3 个月时降低,而两组的最佳矫正视力在治疗后 3 个月时均显著提高。
我们的研究结果表明,口服螺内酯治疗未缓解性中心性浆液性脉络膜视网膜病变的短期疗效与半剂量 PDT 相当,且安全性良好。