Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2022 Apr;63(4):365-371. doi: 10.3349/ymj.2022.63.4.365.
To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy (CSC).
The medical records and imaging data of patients diagnosed with CSC and treated with SPRL were retrospectively reviewed. Central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) at baseline, at 1, 3, and 6 months, and at the last visit after the treatment were analyzed.
In total, 103 patients with 107 eyes were included. The mean age of the patients was 51.5±9.3 years, and 77 (72.0%) were male. The mean follow-up duration was 48.6±40.2 weeks. The mean duration of oral SPRL therapy was 15.5±13.4 weeks. CMT, SRF height, and SFCT improved significantly at 1, 3, and 6 months after SPRL therapy and at the last follow-up. BCVA, however, showed no significant change at any time point. The rate of complete resolution of SRF at 1 month was higher in those with chronic CSC than in those with acute CSC (21.1% vs. 6.0%, respectively). Recurrence occurred in 14 (13.1%) eyes after the complete resolution of SRF. Older age (=0.001), a greater number of previous intravitreal bevacizumab injections (=0.006), and poor initial visual acuity (=0.048) were associated with recurrence. No permanent adverse effects were observed.
Oral SPRL showed therapeutic benefits in patients with CSC in terms of SRF resolution, but relatively frequent recurrence was observed, especially in older patients.
评估口服螺内酯（SPRL）治疗中心性浆液性脉络膜视网膜病变（CSC）的疗效和安全性。
回顾性分析了接受 SPRL 治疗的 CSC 患者的病历和影像学资料。分析了基线、治疗后 1、3 和 6 个月以及治疗后最后一次就诊时的中央黄斑厚度（CMT）、视网膜下液（SRF）高度、中心凹下脉络膜厚度（SFCT）和最佳矫正视力（BCVA）。
共纳入 103 例（107 只眼）患者，患者平均年龄为 51.5±9.3 岁，男性 77 例（72.0%）。平均随访时间为 48.6±40.2 周，口服 SPRL 治疗时间平均为 15.5±13.4 周。SPR 治疗后 1、3 和 6 个月及最后一次随访时，CMT、SRF 高度和 SFCT 均显著改善，而 BCVA 任何时间点均无显著变化。1 个月时，慢性 CSC 患者 SRF 完全消退的比例高于急性 CSC 患者（21.1%比 6.0%）。在 SRF 完全消退后，14 只（13.1%）眼复发。年龄较大（=0.001）、接受更多次玻璃体内贝伐单抗注射（=0.006）和初始视力较差（=0.048）与复发相关。未观察到永久性不良反应。
口服 SPRL 对 CSC 患者在 SRF 消退方面显示出治疗益处，但观察到复发相对频繁，尤其是在老年患者中。
