Venkatesh Ramesh, Agarwal Manisha, Kantha Meha
Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Ther Adv Ophthalmol. 2018 Oct 16;10:2515841418807130. doi: 10.1177/2515841418807130. eCollection 2018 Jan-Dec.
To evaluate the role of oral rifampicin in the management of chronic central serous chorioretinopathy.
Retrospective analysis of patients diagnosed with chronic central serous chorioretinopathy (duration >3 months) and treated with oral rifampicin 600 mg daily for a maximum period of 3 months was carried out. Baseline visual acuity, fundus fluorescein angiography, and optical coherence tomography were recorded and the patients were followed up. Resolution of subretinal fluid and improvement in visual acuity were the main outcome measures. Recurrence of subretinal fluid was noted. Any adverse reaction to the drug was monitored.
Nine eyes of eight patients were included in the study. The average age of the patients was 41.90 years (range 32-52 years). Mean duration of symptoms was 16 months (range 3-60 months). Mean duration of follow-up was 10.11 months (range 3-33 months). Fluorescein angiography showed four eyes with subfoveal leaks and five eyes with diffuse retinal pigment epitheliopathy. Complete resolution of subretinal fluid was achieved in four of the nine eyes - two patients at the end of 1 month, one patient each at the end of 2 and 3 months, respectively. Visual acuity improvement was noted in four of the nine eyes. Three patients had one-line improvement and one patient had a two-line visual improvement. None of the patients had severe adverse events for which the drug had to be discontinued. None of the patients had recurrence of subretinal fluid after the discontinuation of the drug.
Oral rifampicin could provide a useful, effective, and cost-effective alternative for treatment of patients with chronic central serous choroidopathy and evidence of healthier retinal pigment epithelium, those with focal leakage. It was not effective in eyes with diffuse retinal pigment epitheliopathy.
评估口服利福平在慢性中心性浆液性脉络膜视网膜病变治疗中的作用。
对诊断为慢性中心性浆液性脉络膜视网膜病变(病程>3个月)且每日口服600 mg利福平、最长治疗3个月的患者进行回顾性分析。记录基线视力、眼底荧光血管造影和光学相干断层扫描结果,并对患者进行随访。视网膜下液的消退和视力的改善是主要观察指标。记录视网膜下液的复发情况。监测药物的任何不良反应。
8例患者的9只眼纳入研究。患者平均年龄41.90岁(范围32 - 52岁)。平均症状持续时间为16个月(范围3 - 60个月)。平均随访时间为10.11个月(范围3 - 33个月)。荧光血管造影显示4只眼有黄斑下渗漏,5只眼有弥漫性视网膜色素上皮病变。9只眼中有4只视网膜下液完全消退,2例患者在1个月末消退,2例和3例患者分别在2个月末和3个月末各有1例消退。9只眼中有4只视力得到改善。3例患者视力提高1行,1例患者视力提高2行。所有患者均未出现因药物不良反应而停药的严重不良事件。停药后所有患者均未出现视网膜下液复发。
对于慢性中心性浆液性脉络膜病变且视网膜色素上皮健康、有局灶性渗漏的患者,口服利福平可为其提供一种有用、有效且经济高效的治疗选择。对弥漫性视网膜色素上皮病变的眼睛无效。