盐皮质激素受体拮抗剂作为孔源性视网膜脱离修复后持续性视网膜下液的一种潜在治疗选择。
Mineralocorticoid receptor antagonists as a potential treatment option in persistent subretinal fluid following the repair of a rhegmatogenous retinal detachment.
作者信息
El Wardani Mohamad, de Smet Marc D
机构信息
Helvetia Retina Associates, Micro Invasive Ocular Surgery Center, Av du Léman 32, Lausanne, Switzerland.
CNVO Eye Centre, Rle Vautier 10, 1400, Yverdon-les-Bains, Switzerland.
出版信息
Am J Ophthalmol Case Rep. 2022 Dec 31;29:101789. doi: 10.1016/j.ajoc.2022.101789. eCollection 2023 Mar.
PURPOSE
To report the resolution of subretinal fluid persisting more than a year following retinal detachment surgery resolving with a short term course of mineralocorticoid receptor antagonists use.
OBSERVATIONS
A 41 year-old, highly myopic male presented with a temporal rhegmatogenous retinal detachment involving the macula. The tear was treated with a radial sponge without subretinal fluid (SRF) drainage. Post-operatively, SRF persisted for more than 1 year with only slight improvement in visual acuity. On OCT, slow regression of subretinal fluid was noted. In order to stimulate the RPE pump, a systemic mineralocorticoid receptor antagonist (spironolactone 50 mg) was initiated after discussion with the patient. After one month of therapy, there was a complete resolution of SRF and the visual acuity improved. Two years later, there was no reaccumulation of SRF and the visual acuity remained stable.
CONCLUSIONS AND IMPORTANCE
A short term of course of mineralocorticoid receptor antagonist is a potential treatment for persistent subretinal fluid following a successful detachment surgery.
目的
报告视网膜脱离手术后持续一年以上的视网膜下液通过短期使用盐皮质激素受体拮抗剂得以消退的情况。
观察结果
一名41岁的高度近视男性，出现累及黄斑的颞侧孔源性视网膜脱离。撕裂处采用放射状海绵治疗，未进行视网膜下液（SRF）引流。术后，视网膜下液持续存在超过1年，视力仅略有改善。光学相干断层扫描（OCT）显示视网膜下液缓慢消退。为了刺激视网膜色素上皮（RPE）泵，在与患者讨论后开始全身使用盐皮质激素受体拮抗剂（螺内酯50毫克）。治疗一个月后，视网膜下液完全消退，视力改善。两年后，视网膜下液未再积聚，视力保持稳定。
结论与意义
短期使用盐皮质激素受体拮抗剂是视网膜脱离手术成功后持续性视网膜下液的一种潜在治疗方法。
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