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依普利酮治疗慢性中心性浆液性脉络膜视网膜病变

Eplerenone Treatment in Chronic Central Serous Chorioretinopathy.

作者信息

Iqbal Faisal, Iqbal Kashif, Inayat Bilal, Arjumand Sabeen, Ghafoor Zarish, Sattar Werdah, Abbas Kiran

机构信息

Department of Ophthalmology, Layton Rahmatulla Benevolent Trust (LRBT) Eye Hospital, Lahore, PAK.

Department of Pharmacology, Sharif Medical and Dental College, Lahore, PAK.

出版信息

Cureus. 2021 Oct 1;13(10):e18415. doi: 10.7759/cureus.18415. eCollection 2021 Oct.

Abstract

Background The study examined the efficacy of eplerenone in the management of chronic central serous chorioretinopathy (CSCR) with the aim of short-term observations. The study also aimed at observing changes in optical coherence tomography (OCT) parameters and visual acuity. Methodology This retrospective study was conducted at Layton Rahmatulla Benevolent Trust (LRBT) Eye Hospital from September 2019 to October 2020. A thorough ocular examination, color fundus photographs, fluorescein angiography, and macular OCT were performed on all patients. We administered one tablet of 50 mg eplerenone on day one and further advised the use of the same dose for 30 days. After the administration of the tablet, the patients were further analyzed on weeks one, two, and four. On every visit, we examined ophthalmic conditions by visual acuity, slit lamp, and dilated fundus examinations along with macular OCT and measured blood pressure. At follow-up, we measured the levels of serum creatinine at weeks one and four. Student's t-test and chi-square test were used for normal distribution and nominal variables. A p-value < 0.05 was considered statistically significant in all the analyses. Results A total of 15 patients were selected for this research, but unfortunately, two of them withdrew amid the study. For the remaining 13 patients, the mean duration of observing symptoms was three months and three weeks. At one-month follow-up, the mean subretinal fluid (SRF) height (94.18 μm) decreased, but we did not find any statistical significance between the SRF height at one-month follow-up and baseline (113.15 μm). In four patients, the SRF height increased up to 3-30 μm after four months of treatment. In our study, we found some negative consequences of eplerenone therapy in terms of hypertension, cramps, nausea, and migraine. Conclusion We concluded that short-term eplerenone treatment assists in the reduction of the choroidal thickness (CT) and central macular thickness (CMT) among patients with central serous chorioretinopathy. However, eplerenone treatment failed to decrease subretinal fluid height and does not bring any significant improvement in the visual acuity of patients. Some mild adverse effects of the treatment include hypertension, abdominal cramps, nausea, and migraine.

摘要

背景

本研究旨在通过短期观察,检验依普利酮治疗慢性中心性浆液性脉络膜视网膜病变(CSCR)的疗效。该研究还旨在观察光学相干断层扫描(OCT)参数和视力的变化。

方法

本回顾性研究于2019年9月至2020年10月在莱顿·拉赫马图拉慈善信托(LRBT)眼科医院进行。对所有患者进行了全面的眼部检查、彩色眼底照片、荧光素血管造影和黄斑OCT检查。我们在第一天给患者服用一片50毫克的依普利酮,并建议连续30天使用相同剂量。服药后,在第1、2和4周对患者进行进一步分析。每次就诊时,我们通过视力、裂隙灯、散瞳眼底检查以及黄斑OCT检查眼部情况,并测量血压。在随访时,我们在第1周和第4周测量血清肌酐水平。对正态分布和名义变量分别使用学生t检验和卡方检验。在所有分析中,p值<0.05被认为具有统计学意义。

结果

本研究共选取了15例患者,但遗憾的是,其中2例在研究过程中退出。对于其余13例患者,观察症状的平均持续时间为3个月零3周。在1个月的随访中,平均视网膜下液(SRF)高度(94.18μm)下降,但我们未发现1个月随访时的SRF高度与基线(113.15μm)之间存在任何统计学差异。在4例患者中,治疗4个月后SRF高度增加至3 - 30μm。在我们的研究中,我们发现依普利酮治疗在高血压、痉挛、恶心和偏头痛方面存在一些不良后果。

结论

我们得出结论,短期依普利酮治疗有助于降低中心性浆液性脉络膜视网膜病变患者的脉络膜厚度(CT)和中心黄斑厚度(CMT)。然而,依普利酮治疗未能降低视网膜下液高度,也未给患者的视力带来任何显著改善。该治疗的一些轻微不良反应包括高血压、腹部痉挛、恶心和偏头痛。

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