Viggiano Pasquale, Boscia Giacomo, Borrelli Enrico, Evangelista Federica, Giancipoli Ermete, Mastropasqua Rodolfo, Quarta Alberto, Grassi Maria Oliva, Aloia Raffaella, Alessio Giovanni, Toto Lisa, Boscia Francesco
Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy.
Ophthalmology Department, University of Turin, Turin, Italy.
Ophthalmol Ther. 2024 Dec;13(12):3175-3188. doi: 10.1007/s40123-024-01059-x. Epub 2024 Oct 26.
To compare the long-term efficacy of navigated subthreshold micropulse laser (NSML) and continuous oral eplerenone (EPL) in chronic central serous chorioretinopathy (cCSC).
This retrospective observational study included 44 eyes with cCSC (EPL: n = 26; NSML: n = 18). Best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT) were evaluated over 12 months.
Both groups showed significant improvements in BCVA and CMT (p < 0.05). Complete SRF resolution was achieved in both groups by 12 months, with NSML showing faster resolution (2.77 ± 1.43 vs. 6.34 ± 2.17 months, p < 0.001). The EPL group demonstrated significant SFCT reduction at 6 and 12 months (p = 0.001), while the NSML group showed no significant SFCT changes (p > 0.05).
Both NSML and EPL improved retinal morphology and visual function in patients with cCSC. NSML achieved faster SRF resolution, while EPL resulted in more significant choroidal thickness reduction. These findings suggest distinct mechanisms of action: NSML primarily affects the retinal pigment epithelium, while EPL modulates choroidal vasculature. Treatment choice may depend on individual patient characteristics and treatment goals.
比较导航阈下微脉冲激光（NSML）和连续口服依普利酮（EPL）治疗慢性中心性浆液性脉络膜视网膜病变（cCSC）的长期疗效。
这项回顾性观察研究纳入了44只患有cCSC的眼睛（EPL组：n = 26；NSML组：n = 18）。在12个月内评估最佳矫正视力（BCVA）、中心黄斑厚度（CMT）、视网膜下液（SRF）高度和黄斑中心凹下脉络膜厚度（SFCT）。
两组的BCVA和CMT均有显著改善（p < 0.05）。两组在12个月时均实现了SRF完全消退，NSML组的消退速度更快（2.77 ± 1.43个月对6.34 ± 2.17个月，p < 0.001）。EPL组在6个月和12个月时SFCT显著降低（p = 0.001），而NSML组的SFCT无显著变化（p > 0.05）。
NSML和EPL均改善了cCSC患者的视网膜形态和视觉功能。NSML实现了更快的SRF消退，而EPL导致更显著的脉络膜厚度降低。这些发现提示了不同的作用机制：NSML主要影响视网膜色素上皮，而EPL调节脉络膜血管系统。治疗选择可能取决于个体患者特征和治疗目标。
