Department of Ophthalmology, Grenoble Alpes University, Grenoble, France.
Ophtalmopole, Cochin Hospital Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France.
Acta Ophthalmol. 2021 Dec;99(8):e1375-e1381. doi: 10.1111/aos.14809. Epub 2021 Mar 1.
To investigate choroidal blood flow changes after isometric exercise in patients with chronic central serous chorioretinopathy nontreated or treated with mineralocorticoid receptor antagonists (MRA).
Foveolar choroidal laser Doppler flowmetry parameters - velocity (ChVel), volume (ChVol) and blood flow (ChBF) - of 22 eyes of 22 treated patients, 16 eyes of 16 untreated patients and 19 healthy controls were measured during a squatting test. Treatment consisted in MRA administration (eplerenone 50 mg/day or spironolactone 50 mg/day). The experiment comprised three successive periods: 30 seconds of rest, 2 min of continuous squatting exercise, and 150 seconds of recovery. Significance levels were calculated using a generalized estimating equation.
During the squatting period, nontreated CSCR eyes had a similar change in ChVel (p = 0.8), ChVol (p = 0.8), ChBF (p = 0.5) and resistance to healthy eyes. Treated CSCR eyes exhibited significantly smaller changes in ChVel (-0.1 ± 11%, p = 0.04) than healthy eyes (6 ± 8%). No significant difference was found for ChVol and ChBF between the groups. The increase in ChVol from baseline in the nontreated CSCR group (4.4 ± 9%) was lower than that of treated group (6.7%±11%; p = 0.01). Finally, ChBF and ChVel changes in the CSCR groups were not significantly different.
No abnormalities were detected in the changes in ChBF parameters during increased ocular perfusion pressure in nontreated CSCR patients compared with controls. MRA treatment in CSCR patients induced a significant reduction in ChBVel and an increase in ChBVol in response to isometric exercise, suggesting that MRA exerts effects on choroidal vascular changes.
探讨未经治疗或接受盐皮质激素受体拮抗剂（MRA）治疗的慢性中心性浆液性脉络膜视网膜病变患者等长运动后脉络膜血流变化。
采用黄斑区脉络膜激光多普勒血流测量仪检测 22 例（22 只眼）治疗患者、16 例（16 只眼）未经治疗患者及 19 例健康对照者的黄斑区脉络膜血流参数 - 流速（ChVel）、容积（ChVol）和血流（ChBF），并在深蹲试验中进行测量。治疗包括 MRA 给药（依普利酮 50mg/天或螺内酯 50mg/天）。实验包括三个连续阶段：30 秒休息、2 分钟连续深蹲运动和 150 秒恢复。使用广义估计方程计算显著性水平。
在深蹲期间，未经治疗的 CSCR 眼的 ChVel（p=0.8）、ChVol（p=0.8）、ChBF（p=0.5）和阻力与健康眼相似。与健康眼相比，治疗的 CSCR 眼的 ChVel 变化明显较小（-0.1±11%，p=0.04）。各组之间的 ChVol 和 ChBF 无显著差异。未经治疗的 CSCR 组的 ChVol 从基线的增加（4.4±9%）低于治疗组（6.7%±11%；p=0.01）。最后，CSCR 组的 ChBF 和 ChVel 变化无显著差异。
与对照组相比，未经治疗的 CSCR 患者眼内压升高期间，ChBF 参数的变化未发现异常。CSCR 患者接受 MRA 治疗后，等长运动时 ChBVel 显著降低，ChBVol 增加，提示 MRA 对脉络膜血管变化有影响。
