Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany.
Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany.
Eur J Ophthalmol. 2021 Jul;31(4):1885-1891. doi: 10.1177/1120672120952648. Epub 2020 Aug 27.
To assess the morphological and functional outcome of oral eplerenone for treatment of patients with chronic central serous chorioretinopathy (CSC) in a real life experience.
In this retrospective study, we reviewed the clinical files of 30 patients with chronic CSC. All patients were treated with eplerenone for a period of 6 weeks or 3 months depending on the clinical response. Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT) and height of the subretinal fluid (SRF). Comparisons between responders and non-responders were performed to identify factors that were predictive of the treatment response.
All patients were treated with eplerenone 18 ± 20 weeks after onset of the first symptoms. BCVA (LogMAR) improved from 0.2 ± 0.2 to 0.13 ± 0.18 at 6 weeks ( = 0.01) and to 0.09 ± 0.15 at 3 months ( = 0.01). Mean CMT decreased from 409 ± 136 to 323 ± 87 µm at 6 weeks ( = 0.001) and to 298 ± 98 µm at 3 months ( = 0.01). Mean height of SRF decreased from 153 ± 126 to 73 ± 79 µm at 6 weeks ( = 0.001) and to 49 ± 88 µm at 3 months ( = 0.005). Complete resolution of SRF was achieved in 20 patients after 3 months (67%). Reported stress in the medical history was the only statistical significant predictive factor associated with a positive treatment response.
This study showed a statistically significant improvement of the best corrected visual acuity and a significant reduction of macular thickness and subretinal fluid in patients with chronic CSC treated with oral eplerenone, especially in patients under stress.
评估依普利酮口服治疗慢性中心性浆液性脉络膜视网膜病变（CSC）患者的形态和功能结局，为真实临床经验提供参考。
在这项回顾性研究中，我们对 30 例慢性 CSC 患者的临床资料进行了回顾。所有患者均接受依普利酮治疗，治疗时间为 6 周或 3 个月，具体取决于临床反应。主要观察指标包括：最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和视网膜下液（SRF）高度。对有反应者和无反应者进行比较，以确定预测治疗反应的因素。
所有患者均在首发症状后 18 ± 20 周开始接受依普利酮治疗。6 周时 BCVA（LogMAR）从 0.2 ± 0.2 提高到 0.13 ± 0.18（ = 0.01），3 个月时提高到 0.09 ± 0.15（ = 0.01）。CMT 均值从 409 ± 136 降至 323 ± 87 μm（ = 0.001），3 个月时降至 298 ± 98 μm（ = 0.01）。SRF 平均高度从 153 ± 126 降至 73 ± 79 μm（ = 0.001），3 个月时降至 49 ± 88 μm（ = 0.005）。3 个月时，20 例（67%）患者的 SRF 完全消退。病史中报告的应激是与阳性治疗反应相关的唯一具有统计学意义的预测因素。
本研究显示，口服依普利酮治疗慢性 CSC 患者的最佳矫正视力有统计学显著改善，黄斑厚度和视网膜下液显著减少，尤其是应激患者。
