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口服依普利酮治疗慢性中心性浆液性脉络膜视网膜病变后脉络膜血管密度指数的改变。

Choroidal modifications assessed by means of choroidal vascularity index after oral eplerenone treatment in chronic central serous chorioretinopathy.

机构信息

Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.

IRCCS Fondazione G.B. Bietti, Roma, Italy.

出版信息

Eye (Lond). 2023 Apr;37(6):1214-1218. doi: 10.1038/s41433-022-02091-6. Epub 2022 May 19.

Abstract

BACKGROUND

To investigate choroidal vascularity index (CVI) changes after oral eplerenone treatment in chronic central serous chorioretinopathy (cCSC) using the Spectral-domain (SD)-Optical Coherence Tomography (OCT) with enhanced depth imaging (EDI) mode.

METHODS

Thirty-six eyes of 18 patients suffering from cCSC with monolateral foveal subretinal fluid (FSRF) successfully treated with oral eplerenone treatment and 18 age-matched healthy subjects were enroled in this retrospective study. EDI-OCT images obtained using Heidelberg Spectralis OCT device in patients with cCSC and FSRF (group 1); fellow eye (group 2) or healthy patients (healthy) were exported and then imported into image analysis ImageJ software for subsequent quantitative analysis. The main outcome measures were luminal area (LA) and CVI.

RESULTS

A higher value of CVI was detected in group 1 compared to healthy eyes (p = 0.006). LA and CVI significantly reduced during follow up in group 1 and group 2. LA at 120 days was significantly lower compared to all previous time points both in group 1 and group 2 (p < 0.001). Median and [1st -3rd quartile] CVI values were 0.8 [0.7; 1.1] at baseline, 0.8 [0.7; 0.9] at 30 days; 0.7 [0.6; 0.9] at 60 and 90 days and 0.6 [0.5; 0.8] at 120 days in group 1 (p = 0.007) and 0.7 [0.6; 0.9] at baseline, 0.7 [0.7; 0.8] at 30 days; 0.7 [0.6; 0.7] at 60 and 90 days and 0.6 [0.6; 0.7] at 120 days in group 2 (p = 0.018).

CONCLUSIONS

Choroidal vascularity index reduced in cCSC patients after oral eplerenone treatment during follow up both in eyes with SRF and fellow eyes thus demonstrating the effectiveness of mineral corticoid receptor antagonists in recovering choroidal morphology.

摘要

背景

使用带有增强深度成像(EDI)模式的光谱域(SD)-光学相干断层扫描(OCT)来研究慢性中心性浆液性脉络膜视网膜病变(cCSC)患者口服依普利酮治疗后的脉络膜血管指数(CVI)变化。

方法

本回顾性研究纳入了 18 例单侧黄斑区视网膜下液(FSRF)的 cCSC 患者(36 只眼),这些患者均成功接受了口服依普利酮治疗,并招募了 18 名年龄匹配的健康受试者。使用 Heidelberg Spectralis OCT 设备获取 cCSC 患者伴有 FSRF(第 1 组)、对侧眼(第 2 组)或健康患者(健康组)的 EDI-OCT 图像,然后将这些图像导入图像分析软件 ImageJ 进行后续的定量分析。主要观察指标为管腔面积(LA)和 CVI。

结果

第 1 组的 CVI 值明显高于健康眼(p=0.006)。第 1 组和第 2 组在随访过程中 LA 和 CVI 显著降低。第 1 组和第 2 组在 120 天时的 LA 明显低于所有之前的时间点(p<0.001)。第 1 组的基线、30 天、60 天、90 天和 120 天的 CVI 中位数及[1 四分位数至 3 四分位数]分别为 0.8[0.7;1.1]、0.8[0.7;0.9]、0.7[0.6;0.9]和 0.6[0.5;0.8](p=0.007);第 2 组的基线、30 天、60 天、90 天和 120 天的 CVI 中位数及[1 四分位数至 3 四分位数]分别为 0.7[0.6;0.9]、0.7[0.7;0.8]、0.7[0.6;0.7]和 0.6[0.6;0.7](p=0.018)。

结论

在接受依普利酮治疗后,cCSC 患者的脉络膜血管指数在随访期间均降低,包括伴有 FSRF 的眼和对侧眼,这表明了矿物皮质激素受体拮抗剂在恢复脉络膜形态方面的有效性。

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