Sahu Vijaya, Nayak Swatishree, Kumar Aseem, Kashyap Himanshu
Ophthalmology, All India Institute of Medical Sciences, Raipur, IND.
Ophthalmology, Sankara Nethralaya, Chennai, IND.
Cureus. 2024 Apr 22;16(4):e58791. doi: 10.7759/cureus.58791. eCollection 2024 Apr.
This study aimed to investigate optical coherence tomography (OCT) biomarkers as potential predictors of treatment response in chronic central serous chorioretinopathy (CSCR).
It was a retrospective cohort study that included 42 patients with chronic CSCR. After complete ocular and hematological examinations, all patients received 50 mg/day of oral eplerenone for three months and were followed for at least six months. All participants were divided into two groups: Group 1 participants with a positive response to treatment (complete resolution of subretinal fluid (SRF) at six months) and Group 2 poor responders (moderate or less than 50% reduction in SRF from baseline). The primary outcome measure was the resolution of SRF, and various OCT biomarkers like central macular thickness (CMT), pigment epithelial detachments (PED), double-layer sign, elongation of the photoreceptor's outer segment, the integrity of the external limiting membrane, the integrity of the ellipsoid zone, hyperreflective foci in the outer segment, and subretinal deposits in the SRF were assessed.
The mean age was 41.33 ± 10.75 years, and 34 participants were male. Thirty-seven (88.1%) of the participants had good responses to eplerenone, with the mean height of SRF decreasing significantly from a maximum of 269.74 µm to a minimum of 21.86 µm at six months (p<0.001). The mean CMT decreased from the first visit time point to the third visit time (p<0.001). Logistic regression analysis assessed the absence of PED and double-layer signs associated with a good response.
The eplerenone therapy seems to be efficient for chronic CSCR, and OCT can be an invaluable aid to the treating physician.
本研究旨在探讨光学相干断层扫描（OCT）生物标志物作为慢性中心性浆液性脉络膜视网膜病变（CSCR）治疗反应潜在预测指标的可能性。
这是一项回顾性队列研究，纳入了42例慢性CSCR患者。在完成眼部和血液学检查后，所有患者接受每日50毫克依普利酮口服治疗三个月，并随访至少六个月。所有参与者被分为两组：第1组为治疗反应阳性者（六个月时视网膜下液（SRF）完全消退），第2组为反应不佳者（SRF较基线降低中度或低于50%）。主要观察指标是SRF的消退情况，并评估了各种OCT生物标志物，如中心黄斑厚度（CMT）、色素上皮脱离（PED）、双层征、光感受器外段延长、外界膜完整性、椭圆体带完整性、外段高反射灶以及SRF中的视网膜下沉积物。
平均年龄为41.33±10.75岁，34名参与者为男性。37名（88.1%）参与者对依普利酮反应良好，SRF的平均高度在六个月时从最高269.74微米显著降至最低21.86微米（p<0.001）。平均CMT从首次就诊时间点到第三次就诊时间有所下降（p<0.001）。逻辑回归分析评估了无PED和双层征与良好反应相关。
依普利酮治疗慢性CSCR似乎有效，OCT可为治疗医生提供宝贵帮助。
