Loya Hina, Ghoghari Hunain, Rizvi Syed Fawad, Khan Abdullah
Dr. Hina Loya, MBBS. Layton Rahamatullah Benevolent Trust (LRBT), Free Base Eye Hospital, Korangi 2 ½, Karachi, Pakistan.
Dr. Hunain Ghoghari, MBBS, MRCSEd (Ophth). Layton Rahamatullah Benevolent Trust (LRBT), Free Base Eye Hospital, Korangi 2 ½, Karachi, Pakistan.
Pak J Med Sci. 2019 Nov-Dec;35(6):1687-1690. doi: 10.12669/pjms.35.6.990.
To study the effect of reducing the duration of rifampicin therapy in the treatment of Chronic Central Serous Chorioretinopathy.
This is interventional study conducted in Layton Rahmatullah Benevolent Trust, Free Base Eye Hospital Korangi, Karachi from February 2017 - December 2018. This randomized controlled comparative study included two groups, Groups-A comprised of 48 eyes of 40 cases with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 600mg for one month, and Group-B consisted of 43 eyes of 40 controls with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 300mg once daily for three months as previously stated in literature. To access the effect of therapy in both the groups, pre-treatment visual acuity on the logMAR and Optical Coherent Tomography (OCT, Heidelberg spectralis) for CMT were performed and repeated on the 1 and 3 month post-treatment. Patients were also followed for 6 months to access any recurrence.
On comparing the two groups, Group-A had improvement in VA and CMT after one month therapy of Rifampicin, Pre-treatment mean VA in Group-A was 0.85 ± 0.19 as compared to the pre-treatment mean VA in Group-B i.e. 0.74+/- 0.208, while the pre-treatment mean CMT was 609.0 ± 178.29 µm in Group-A, and 600.0 +/- 155.09 µm in Group-B respectively. After 1 month of therapy, the visual status, and CMT in Group-A was 0.29+/- 0.21 and 311.6 +/- 89.9, while Group-B, VA was 0.598 +/- 0.23 (p value 0.001%) and CMT was 512.30 +/- 148.37 (p-value 0.001%). Rifampicin was continued in Group-B till three months, and patients were re-accessed but there was no difference in VA and CMT statically. During the 3 and 6 months of follow up no relapses were reported.
This comparative study showed that the group receiving oral rifampicin 600mg for one month showed better outcome at one month and third month than the group receiving oral rifampicin at a dose of 300mg once daily for three months. This gives a better compliance and lower the risk of drug induced side effects.
研究缩短利福平治疗疗程对慢性中心性浆液性脉络膜视网膜病变的治疗效果。
本研究为干预性研究，于2017年2月至2018年12月在卡拉奇科兰吉的莱顿·拉赫马图拉慈善信托免费基础眼科医院开展。这项随机对照比较研究包括两组，A组由40例慢性中心性浆液性脉络膜视网膜病变患者的48只眼组成，给予口服利福平低剂量即600mg，为期1个月；B组由40例慢性中心性浆液性脉络膜视网膜病变对照患者的43只眼组成，给予口服利福平低剂量即如文献中所述每日300mg，为期3个月。为评估两组的治疗效果，在治疗前、治疗后1个月和3个月进行了基于对数最小分辨角视力（logMAR）的视力检查以及光学相干断层扫描（OCT，海德堡光谱仪）测量中心黄斑厚度（CMT）。对患者进行了6个月的随访以评估是否有复发情况。
比较两组发现，A组在接受利福平治疗1个月后视力和CMT有所改善，A组治疗前平均视力为0.85± 0.19，而B组治疗前平均视力为0.74 ± 0.208，A组治疗前平均CMT为609.0 ± 178.29 µm，B组为600.0 ± 155.09 µm。治疗1个月后，A组的视力状况和CMT分别为0.29 ± 0.21和311.6 ± 89.9，而B组视力为0.598 ± 0.23（p值0.001%），CMT为512.30 ± 148.37（p值0.001%）。B组继续服用利福平直至3个月，再次评估患者，但视力和CMT在统计学上无差异。在3个月和6个月的随访期间，未报告复发情况。
这项比较研究表明，接受口服利福平600mg为期1个月的组在1个月和3个月时的治疗效果优于接受口服利福平每日300mg为期3个月的组。这具有更好的依从性，并降低了药物引起的副作用风险。
