螺内酯作为中心性浆液性脉络膜视网膜病变囊泡型的治疗选择。
SPIRONOLACTONE AS A THERAPEUTIC ALTERNATIVE FOR THE BULLOUS VARIANT OF CENTRAL SEROUS CHORIORETINOPATHY.
机构信息
Retina Service, Unidad Nacional de Oftalmología, Guatemala City, Guatemala.
出版信息
Retin Cases Brief Rep. 2020 Fall;14(4):381-385. doi: 10.1097/ICB.0000000000000719.
PURPOSE
To report a case of the bullous variant of central serous chorioretinopathy successfully treated with spironolactone, a mineralocorticoid receptor antagonist.
METHODS
Case report of a patient including fluorescein angiography, optical coherence tomography, and color fundus photography.
RESULTS
Initially managed as a multifocal choroiditis, the use of oral and peribulbar corticoids worsened the serous retinal detachment. Taking in consideration this response, she was then diagnosed with a bullous variant of central serous chorioretinopathy and treated with 50 mg of spironolactone per day. Resolution of the serous retinal detachment, decrease in choroidal thickness on optical coherence tomography, and absence of leaks in fluorescein angiography was achieved 2 months posterior to the first dose of oral spironolactone.
CONCLUSION
We suggest the use of mineralocorticoid receptor antagonists, such as spironolactone, as a therapeutic alternative to more aggressive available treatments for the bullous variant of central serous chorioretinopathy.
目的
报告一例成功用螺内酯（一种盐皮质激素受体拮抗剂）治疗的大疱性中心性浆液性脉络膜视网膜病变。
方法
包括荧光素血管造影、光学相干断层扫描和眼底彩色照相在内的患者病例报告。
结果
最初被诊断为多灶性脉络膜炎，口服和球周皮质类固醇的使用使浆液性视网膜脱离恶化。考虑到这种反应，然后诊断为大疱性中心性浆液性脉络膜视网膜病变，并每天用 50 毫克螺内酯治疗。在首次口服螺内酯后 2 个月，浆液性视网膜脱离得到解决，光学相干断层扫描上脉络膜厚度减少，荧光素血管造影无渗漏。
结论
我们建议使用盐皮质激素受体拮抗剂，如螺内酯，作为治疗大疱性中心性浆液性脉络膜视网膜病变的更积极的现有治疗方法的替代方案。
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