Zucchiatti Ilaria, Sacconi Riccardo, Parravano Maria Cristina, Costanzo Eliana, Querques Lea, Montorio Daniela, Bandello Francesco, Querques Giuseppe
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Neurological, Biomedical and Movement Sciences, Eye Clinic, University of Verona, Verona, Italy.
Ophthalmol Ther. 2018 Jun;7(1):109-118. doi: 10.1007/s40123-018-0121-2. Epub 2018 Feb 13.
To investigate the effects of eplerenone compared to observation in the treatment of acute central serous chorioretinopathy (CSC).
Charts of consecutive patients with a diagnosis of acute CSC (visual symptoms < 12 weeks) were reviewed. Included patients were divided into a treatment group (treated with eplerenone) and a control group (observation). Main outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), height of subretinal fluid (SRF) and subfoveal choroidal thickness (CT) at 1 and 3 months in the two groups.
Fifteen eyes of 15 patients (2 female, 13 male) and 12 eyes of 12 patients (1 female, 11 male [p = 1.000]) were included in the treatment and control groups, respectively. The mean age was 44 ± 9 (30-65) and 47 ± 11 years (28-66 years, p = 0.493), respectively. In the treatment group, BCVA improved significantly at 1 month (p = 0.018) and 3 months of follow-up (p = 0.011), while a non-significant improvement was seen in the control group. At 3 months, 12 of 15 eyes (80%) in the treatment group demonstrated complete SRF resolution, versus 3 of 12 eyes (25%) in the control group (p = 0.007). In the treatment group, SRF and CMT were significantly reduced at the 1-month follow-up (p = 0.014, p = 0.028, respectively) and the 3-month follow-up (p < 0.001 for both analyses), while in the control group the changes were not statistically significant. Eplerenone was well tolerated in all patients.
Patients affected by acute CSC treated with eplerenone achieved greater and faster resolution of the disease compared to the observation group. Eplerenone may represent an attractive new first-line treatment option for acute CSC.
研究依普利酮与观察等待相比在治疗急性中心性浆液性脉络膜视网膜病变（CSC）中的效果。
回顾连续诊断为急性CSC（视觉症状＜12周）患者的病历。纳入患者分为治疗组（接受依普利酮治疗）和对照组（观察等待）。主要观察指标包括两组在1个月和3个月时最佳矫正视力（BCVA）、中心黄斑厚度（CMT）、视网膜下液（SRF）高度和黄斑中心凹下脉络膜厚度（CT）的变化。
治疗组纳入15例患者的15只眼（2例女性，13例男性），对照组纳入12例患者的12只眼（1例女性，11例男性[p = 1.000]）。平均年龄分别为44±9岁（30 - 65岁）和47±11岁（28 - 66岁，p = 0.493）。在治疗组，随访1个月（p = 0.018）和3个月（p = 0.011）时BCVA显著改善，而对照组改善不显著。3个月时，治疗组15只眼中12只眼（80%）SRF完全消退，对照组12只眼中3只眼（25%）SRF完全消退（p = 0.007）。在治疗组，随访1个月时SRF和CMT显著降低（分别为p = 0.014，p = 0.028），随访3个月时两者也显著降低（两项分析p均＜0.001），而对照组的变化无统计学意义。所有患者对依普利酮耐受性良好。
与观察组相比，接受依普利酮治疗的急性CSC患者疾病消退更显著且更快。依普利酮可能是急性CSC一种有吸引力的新一线治疗选择。
