Long-term results and recurrence rates after spironolactone treatment in non-resolving central serous chorio-retinopathy (CSCR).

Autor: Herold TR; University Eye Hospital - LMU, 80539, Munich, Germany. Tina.Herold@med.uni-muenchen.de.; Department of Ophthalmology, Ludwig-Maximilians Universität, 80539, Munich, Germany. Tina.Herold@med.uni-muenchen.de.; Klinikum der Universität München, Campus Innenstadt, Mathildenstrasse 8, D-80336, Munich, Germany. Tina.Herold@med.uni-muenchen.de., Rist K; University Eye Hospital - LMU, 80539, Munich, Germany.; Department of Ophthalmology, Ludwig-Maximilians Universität, 80539, Munich, Germany.; Klinikum der Universität München, Campus Innenstadt, Mathildenstrasse 8, D-80336, Munich, Germany., Priglinger SG; University Eye Hospital - LMU, 80539, Munich, Germany.; Department of Ophthalmology, Ludwig-Maximilians Universität, 80539, Munich, Germany.; Klinikum der Universität München, Campus Innenstadt, Mathildenstrasse 8, D-80336, Munich, Germany., Ulbig MW; Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675, Munich, Germany., Wolf A; University Eye Hospital - LMU, 80539, Munich, Germany.; Department of Ophthalmology, Ludwig-Maximilians Universität, 80539, Munich, Germany.; Klinikum der Universität München, Campus Innenstadt, Mathildenstrasse 8, D-80336, Munich, Germany.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2017 Feb; Vol. 255 (2), pp. 221-229. Date of Electronic Publication: 2016 Jul 31.
DOI: 10.1007/s00417-016-3436-5
Abstrakt: Purpose: To evaluate the long-term results of spironolactone in non-resolving central serous chorio-retinopathy (CSCR) and recurrence rates of CSCR.
Methods: Interventional uncontrolled open-label prospective clinical trial of patients with non-resolving CSCR who were treated with spironolactone 50 mg daily (Spironolacton AL® 50 mg, ALIUD PHARMA) for up to 16 weeks. Follow-up visits were performed at 3, 6, 9, and 12 months. Retreatment criteria for recurrence were: gain in sub-retinal fluid (SRF) of more than 25 % plus/or increase of central retinal thickness (CRT) of more than 50 μm plus visual symptoms compared to last visit.
Main Outcome Measures: 12-month efficacy of upload treatment with spironolactone. Secondary outcome measure was the recurrence rate at 6, 9, and 12 months.
Results: Of the 21 study eyes treated, 71 % (n = 15) showed significant improvement or complete regression on OCT examination over 12 months. Nineteen percent of the patients (n = 4) showed a stable course from visit 1 to visit 12. The overall reduction of sub-retinal fluid from visit 1 (156 μm ± 131 SD) to visit 12 (53 μm ± 93 SD) was statistically significant (p = 0.003). The change of mean visual acuity (log MAR) from 0.25 (± 0.17 SD) at baseline to 0.17 (± 0.18 SD) at visit 12 was statistically significant, with p = 0.044.
Conclusion: Our results confirm a positive effect of spironolactone in non-resolving CSCR in 71 % of cases. Evaluation of recurrence rates and retreatments showed good results in patients who responded to spironolactone primarily. A prospective randomized trial may provide better data about this non-invasive treatment.
Databáze: MEDLINE
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