Department of Retina & Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Bengaluru, 560010, India.
BMC Ophthalmol. 2020 Jun 5;20(1):219. doi: 10.1186/s12886-020-01499-6.
Minoxidil solution has routinely been used for decades for the treatment of androgenic alopecia. Central serous chorioretinopathy (CSCR) is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. In this report, we describe a case of a 41-year-old young man who developed CSCR following prolonged therapy with topical Minoxidil solution and was treated with oral eplerenone.
A 41-year-old male presented to the retina clinic with complaints of seeing a black spot, blurred vision and metamorphopsia involving the right eye for the past 4 months. He was on treatment for androgenic alopecia with topical 5% Minoxidil application on scalp two times a day. He noticed the symptoms 8 months after starting the treatment and had stopped the medication since the past 2 months. On examination, best-corrected visual acuity was 20/20 in both eyes. Fundoscopic examination of the right eye with +78D lens on slit lamp revealed the presence of subretinal fluid and few focal spots of retinal pigment epithelial alterations. Optical coherence tomography scan evaluation showed the presence of subretinal fluid (SRF) and pachychoroid supporting the diagnosis of CSCR. Indocyanine green angiography revealed dilated hyperpermeable choroidal vasculature on the nasal side of the fovea in the early and later phases of the angiogram. The patient was diagnosed with CSCR as a possible consequence of the topical minoxidil solution. Patient was asked to avoid future use of Minoxidil and was started on oral eplerenone therapy 50 mg/day for 4 consecutive weeks. One month later, there was complete resolution of his symptoms and SRF. At the final follow-up visit, 2 months after starting the therapy, there was no recurrence of SRF.
CSCR is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. While we found oral eplerenone to be safe and effective, further studies would be required before it can be routinely used in the population.
米诺地尔溶液已常规使用数十年，用于治疗雄激素性脱发。长期局部使用米诺地尔治疗雄激素性脱发后，会出现罕见的中央性浆液性脉络膜视网膜病变（CSCR）。在此报告中，我们描述了一位 41 岁的年轻男性，他在长期使用局部米诺地尔溶液治疗后发生 CSCR，并接受了口服依普利酮治疗。
一位 41 岁男性因右眼出现黑点、视力模糊和变形 4 个月而到视网膜诊所就诊。他因雄激素性脱发，每天两次在头皮上涂抹 5%米诺地尔溶液进行治疗。他在开始治疗 8 个月后出现症状，并在过去 2 个月停止了治疗。检查时，双眼最佳矫正视力均为 20/20。在裂隙灯显微镜下用+78D 镜片检查右眼时，发现存在视网膜下液和少数视网膜色素上皮改变的局灶性斑点。光学相干断层扫描评估显示存在视网膜下液（SRF）和肥厚脉络膜，支持 CSCR 的诊断。吲哚青绿血管造影显示在造影的早期和晚期，在黄斑鼻侧可见扩张的高通透性脉络膜血管。患者被诊断为 CSCR，可能是由于局部米诺地尔溶液引起的。患者被要求避免未来使用米诺地尔，并开始每天口服依普利酮 50mg，连续服用 4 周。一个月后，他的症状和 SRF 完全消退。在最后一次随访时，即开始治疗后 2 个月，没有 SRF 复发。
CSCR 是长期局部使用米诺地尔治疗雄激素性脱发后出现的罕见副作用。虽然我们发现口服依普利酮安全有效，但还需要进一步研究，才能在人群中常规使用。
