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口服螺内酯与光动力疗法治疗未缓解的中心性浆液性脉络膜视网膜病变的视觉/解剖学结局和复发率比较。

COMPARISON OF VISUAL/ANATOMICAL OUTCOMES AND RECURRENCE RATE BETWEEN ORAL SPIRONOLACTONE AND PHOTODYNAMIC THERAPY FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY.

机构信息

Department of Ophthalmology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.

Department of Ophthalmology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

出版信息

Retina. 2020 Jun;40(6):1191-1199. doi: 10.1097/IAE.0000000000002507.

DOI:10.1097/IAE.0000000000002507
PMID:30897068
Abstract

PURPOSE

To compare long-term visual/anatomical outcomes and recurrence rate between oral spironolactone (SPRL) treatment and half-dose photodynamic therapy for nonresolving central serous chorioretinopathy.

METHODS

This retrospective, interventional, comparative study included 50 nonresolving central serous chorioretinopathy patients who had exhibited subretinal fluid (SRF) accumulation for >3 months. Of the 50 patients, 26 (26 eyes) received oral SPRL treatment and 24 (24 eyes) received half-dose photodynamic therapy. Best-corrected visual acuity, central subfield thickness, SRF height, and subfoveal choroidal thickness were compared between groups at 1, 2, 3, 6, and 12 months after treatment by using repeated-measures analysis of variance.

RESULTS

After treatment, best-corrected visual acuity, central subfield thickness, and SRF height significantly improved in both groups, compared with baseline. There were no significant differences in best-corrected visual acuity, central subfield thickness, or SRF height between the two groups, with the exception of 3 and 12 months of follow-up for central subfield thickness (P = 0.016 and P = 0.028, respectively) and 3 months of follow-up for SRF height (P = 0.039). However, recurrence was more likely to occur in the oral SPRL group than in the half-dose photodynamic therapy group (P = 0.002).

CONCLUSION

Oral SPRL treatment for nonresolving central serous chorioretinopathy showed good long-term visual/anatomical outcomes, compared with half-dose photodynamic therapy. However, recurrence was more likely to occur when using oral SPRL.

摘要

目的

比较口服螺内酯(SPRL)治疗与半剂量光动力疗法治疗非愈合性中心性浆液性脉络膜视网膜病变的长期视觉/解剖学结果和复发率。

方法

本回顾性、干预性、对照研究纳入了 50 例非愈合性中心性浆液性脉络膜视网膜病变患者,这些患者均表现为视网膜下液(SRF)积聚超过 3 个月。在这 50 例患者中,26 例(26 只眼)接受口服 SPRL 治疗,24 例(24 只眼)接受半剂量光动力疗法。治疗后 1、2、3、6 和 12 个月,采用重复测量方差分析比较两组最佳矫正视力、中央视网膜厚度、SRF 高度和中心凹下脉络膜厚度。

结果

与基线相比,两组治疗后最佳矫正视力、中央视网膜厚度和 SRF 高度均显著改善。两组间最佳矫正视力、中央视网膜厚度或 SRF 高度无显著差异,除中央视网膜厚度在 3 个月和 12 个月随访时(P=0.016 和 P=0.028)和 SRF 高度在 3 个月随访时(P=0.039)存在差异外。然而,口服 SPRL 组的复发率高于半剂量光动力疗法组(P=0.002)。

结论

与半剂量光动力疗法相比,口服 SPRL 治疗非愈合性中心性浆液性脉络膜视网膜病变具有良好的长期视觉/解剖学结果。然而,口服 SPRL 治疗时更可能发生复发。

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