Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.
Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China.
Transl Vis Sci Technol. 2024 Aug 1;13(8):19. doi: 10.1167/tvst.13.8.19.
To compare the efficacy and safety of subthreshold micropulse laser (SML) and spironolactone therapy for treating chronic central serous chorioretinopathy (CSC).
This was a quasi-randomized controlled trial. Eligible patients were quasi-randomized at a 1:1 ratio to receive SML or oral spironolactone and were assessed at 3 months after treatment.
A total of 84 patients (90 eyes) were randomly assigned to receive SML (n = 45) or spironolactone (n = 39) initially. At last follow-up, 59.5% of patients in the SML group had complete resolution of subretinal fluid (SRF) compared to 43.6% in spironolactone group (P = 0.362). The mean visual acuity did not significantly improve between the two groups (0.38 ± 0.44 vs. 0.43 ± 0.43 logMAR). The central retinal thickness was decreased from 335.06 ± 120.25 µm to 222.15 ± 94.90 µm in the SML group and from 308.02 ± 90.69 µm to 257.27 ± 102.28 µm in the spironolactone group. After treatment, subfoveal choroidal thickness, total choroidal area, and stromal and luminal choroidal area were significantly lower in the spironolactone group as compared to the SML group. During the entire visit, the recurrence rate of SRF was 9.1% in the SML group compared to 35.3% in the spironolactone group. Slight adverse events occurred more frequently in the spironolactone group (0% vs. 16%).
Both SML and oral spironolactone were effective and safe treatments to ameliorate retinal anatomical structures for chronic CSC. A lower recurrence rate and fewer adverse effects were observed in the SML group, and better choroidal structure recovery was seen in the spironolactone group.
The investigation of SML and oral spironolactone may inform evidence-based clinical decisions for chronic CSC patients.
比较阈下微脉冲激光（SML）和螺内酯治疗慢性中心性浆液性脉络膜视网膜病变（CSC）的疗效和安全性。
这是一项准随机对照试验。符合条件的患者以 1:1 的比例进行准随机分组，分别接受 SML 或口服螺内酯治疗，并在治疗后 3 个月进行评估。
共有 84 名患者（90 只眼）被随机分配接受 SML（n = 45）或螺内酯（n = 39）治疗。末次随访时，SML 组 59.5%的患者完全消退了视网膜下液（SRF），而螺内酯组为 43.6%（P = 0.362）。两组之间视力无显著提高（0.38 ± 0.44 与 0.43 ± 0.43 logMAR）。SML 组中央视网膜厚度从 335.06 ± 120.25µm 降至 222.15 ± 94.90µm，螺内酯组从 308.02 ± 90.69µm 降至 257.27 ± 102.28µm。治疗后，螺内酯组较 SML 组的下视网膜下脉络膜厚度、总脉络膜面积、基质和管腔脉络膜面积均显著降低。整个随访期间，SML 组 SRF 复发率为 9.1%，螺内酯组为 35.3%。螺内酯组不良反应发生率较高（0%比 16%）。
SML 和口服螺内酯均能有效改善慢性 CSC 的视网膜解剖结构，且安全。SML 组复发率较低，不良反应较少，螺内酯组脉络膜结构恢复较好。
本文是机器翻译，仅供参考。
