scholarly journals Assessment Of Choroidal And Retinal Changes In Cases Of Central Serous Chorioretinopathy Treated With Oral Eplerenone

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N A Abdelaziz ◽  
T M Abdalla ◽  
Y A Thabet ◽  
S M Fawzy
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Standard Dose ◽  
Fluid Volume ◽  
Base Line ◽  
Central Serous Retinopathy ◽  
Chronic Central Serous Chorioretinopathy ◽  
Once Daily ◽  
Significant Difference ◽  
Treatment Contrast ◽  
Main Intervention

Abstract Aim of the Work This prospective analysis was planned for patients with chronic central serous retinopathy (CSR) more than three months who receive oral Eplerenone for treatment. It is aimed to reduce &resolve sub retinal fluid with improving anatomical and physiological visual functions. Patient &Methods sixteen eyes with untreated chronic Central Serous Chorioretinopathy patients who recruited from the ophthalmic clinic. Main intervention is medication by standard dose of Eplerenone, 50mg once daily. Investigated by Optical Coherence Topography at base line, one month after treatment and three months later. Over the course of the study, patients were monitored for side effects, visual and anatomical response to the medication. Results Significant difference in BCVA is found that was 0.675 ±0.2696 at base line to 0.48125±0.2287 after one month after treatment and to 0.04375±0.07274 three months after treatment, (p = 0.000). Sub retinal fluid measurements were improved significantly between each two visits as horizontal fluid volume is improved from 2137 ±987.93 at base line to1559.875 ±677.60 after one month after treatment and to 0 three months after treatment. Vertical fluid volume is improved from 203.125 ±118.73 at base line to122±49.876 after one month after treatment and to 0 three months after treatment. Central sub field thickness were improved significantly between each two visits as it is improved from 372.375 ±92.994 at base line to331.8125 ±90.283 after one month after treatment and to 250.25±25.970 three months after treatment. Contrast sensitivity improved significantly between each two visits as it is improved from 8.7625 ±4.029 at base line to 5.1968±3.227after one month after treatment and to 1.4968±0.4750 three months after treatment. Choroidal thickness was improved significantly between each two visits as it was improved from 267.9375 ±67.451 at base line to222±52.262 after one month after treatment and to 174.0625±23.713 three months after treatment. 100% of the patients complained from positive scotoma at base line, Improved to 44% of the patients complained from positive scotoma one month after treatment, improved to 0% three months after treatment. Conclusion Eplerenone therapy resulted in significant anatomic and visual improvements in eyes with chronic central serous Chorioretinopathy.

scholarly journals Routine Clinical Practice Treatment Outcomes of Eplerenone in Acute and Chronic Central Serous Chorioretinopathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Katrin Fasler ◽  
Jeanne M. Gunzinger ◽  
Daniel Barthelmes ◽  
Sandrine A. Zweifel
Keyword(s):  
Clinical Practice ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Routine Clinical Practice ◽  
Secondary Outcome ◽  
Maximum Height ◽  
Separate Analysis ◽  
Chronic Central Serous Chorioretinopathy ◽  
Cox Regression Analysis ◽  
Significant Difference

Purpose: To evaluate efficacy of eplerenone therapy vs. observation on resolution of subretinal fluid (SRF) in patients with acute and chronic central serous chorioretinopathy (CSCR) in routine clinical practice.Methods: Retrospective comparative case series of eyes diagnosed with CSCR treated with eplerenone or observation. Primary outcome measure was maximum height of SRF at 12 months. Secondary outcome was percentage of eyes with complete resolution of SRF, percentage of eyes with reduction of SRF ≥50%, and best corrected visual acuity (VA) at 12 months. Separate analysis was conducted for eyes with acute and chronic CSCR.Results: Sixty-eight eyes of 60 patients (82% male) were included. Eleven of the 38 eyes with acute CSCR, and seven of the 30 eyes with chronic CSCR, received eplerenone. Subretinal fluid decreased from baseline to 12 months in acute (287 ± 221 to 31 ± 63 µm) and chronic (148 ± 134 to 40 ± 42 µm) CSCR. Kaplan-Meier curves were similar for treated and observed eyes and COX regression analysis did not show a significant difference in SRF resolution in treated vs. observed eyes (p = 0.6 for acute, p = 0.2 for chronic CSCR).Conclusion: This routine clinical practice outcome study did not show evidence of efficacy of eplerenone on resolution of SRF in acute nor chronic CSCR.

Long-term outcomes of half-fluence photodynamic therapy and eplerenone in chronic central serous chorioretinopathy: A comparative study

2021 ◽  
pp. 112067212199105
Author(s):  
George Manayath ◽  
Shishir Verghese ◽  
Ratnesh Ranjan ◽  
Hitesh Agrawal ◽  
Amishi Khanna ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Comparative Study ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Subretinal Fluid ◽  
Long Term Outcomes ◽  
Chronic Central Serous Chorioretinopathy ◽  
Intergroup Comparison ◽  
Significant Difference

Aims: To compare the long-term outcomes in chronic central serous chorioretinopathy (cCSC) following half-fluence photodynamic therapy (HF-PDT) and oral eplerenone treatment. Methods: This retrospective comparative study included consecutive patients of cCSC treated with either HF-PDT or eplerenone. The treatment outcomes of the two groups were analyzed at 3-month, 6-month, and 12-month post-treatment. Results: This study included 20 eyes (20 patients) in HF-PDT group, and 18 eyes (18 patients) in eplerenone group. All baseline parameters in HF-PDT and eplerenone groups were comparable including neurosensory detachment height (217.05 ± 140.25 µm vs 178.05 ± 164.24 µm respectively, p = 0.09), best-corrected visual acuity (BCVA) (logMAR 0.24 ± 0.13 vs logMAR 0.46 ± 0.37 respectively, p = 0.1), and subfoveal choroidal thickness (SFCT) [427.4 ± 117.4 µm vs 456.38 ± 119.25 µm respectively, p = 0.45]. HF-PDT resulted in complete resolution of neurosensory detachment in higher proportion of eyes compared to eplerenone at each follow-up visits (3 months: 90% vs 27.7%, p = 0; 6 months: 100% vs 61.1%, p = 0.003; and 12 months: 100% vs 70%, p = 0.03) with a significantly shorter duration to resolution (3.3 ± 0.9 months vs 5.8 ± 3.3 months respectively, p = 0.02). Intergroup comparison showed no significant difference between mean BCVA ( p = 0.38 at 3 months, p = 0.14 at 6 months, and p = 0.19 at 12 months). Mean SFCT at 12 months of the two groups differed significantly ( p = 0.003) due to increased choroidal thickness of eplerenone group. Conclusion: HF-PDT has a superior efficacy to achieve faster, greater and long-lasting resolution of subretinal fluid in cCSC compared to eplerenone therapy.

Evaluation of the changes in choroidal thickness in patients with central serous chorioretinopathy as measured by optical coherence tomography

2021 ◽  
Vol 2 (1) ◽  
pp. 31-36
Author(s):  
Ragai Magdy Hatata ◽  
◽  
Sherin Hassan Sadek ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Subretinal Fluid ◽  
Base Line ◽  
Optical Coherence ◽  
Significant Difference ◽  
And Control ◽  
Fellow Eyes

AIM: To study the changes in choroidal thickness in central serous chorioretinopathy (CSCR) over a 3mo follow-up using spectral domain optical coherence tomography (SD-OCT). METHODS: This prospective study included 60 eyes, both eyes of 20 patients (mean age: 33.65±5.24y) with classic acute unilateral central serous chorioretinopathy and normal fellow eye and 20 eyes as healthy controls. Fluorescein angiography and OCT were done. The subfoveal choroidal thickness (SFCT), central macular thickness (CMT), 1000 μm temporal and nasal to the centre of the fovea and the subretinal fluid were measured. RESULTS: There was a statistically significant difference in SFCT among the three groups at the three different locations. SFCT in eyes with CSCR (372.40±34.39 μm) was significantly greater than that in each of the unaffected fellow eyes (302.10±8.9 μm) and control eyes (279.80±14.49 μm) at the base line and after 3mo follow-up. The mean CMT in CSCR was 317±141.86 μm, with a statistically significant positive correlation between SFCT and CMT. CONCLUSION: The increase in the choroidal thickness at different locations as well as hyper-dilated and hyper-permeable vessels known as “pachychoroid” seems to play an important role in a broad spectrum of diseases that includes central serous chorioretinopathy.

scholarly journals Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Hina Loya ◽  
Hunain Ghoghari ◽  
Syed Fawad Rizvi ◽  
Abdullah Khan
Keyword(s):  
Comparative Study ◽  
Central Serous Chorioretinopathy ◽  
P Value ◽  
Drug Induced ◽  
Chronic Central Serous Chorioretinopathy ◽  
Once Daily ◽  
Reduced Dose ◽  
Group A ◽  
Pre Treatment ◽  
Group B

Objective: To study the effect of reducing the duration of rifampicin therapy in the treatment of Chronic Central Serous Chorioretinopathy. Methods: This is interventional study conducted in Layton Rahmatullah Benevolent Trust, Free Base Eye Hospital Korangi, Karachi from February 2017 - December 2018. This randomized controlled comparative study included two groups, Groups-A comprised of 48 eyes of 40 cases with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 600mg for one month, and Group-B consisted of 43 eyes of 40 controls with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 300mg once daily for three months as previously stated in literature. To access the effect of therapy in both the groups, pre-treatment visual acuity on the logMAR and Optical Coherent Tomography (OCT, Heidelberg spectralis) for CMT were performed and repeated on the 1st and 3rd month post-treatment. Patients were also followed for 6 months to access any recurrence. Results: On comparing the two groups, Group-A had improvement in VA and CMT after one month therapy of Rifampicin, Pre-treatment mean VA in Group-A was 0.85 ± 0.19 as compared to the pre-treatment mean VA in Group-B i.e. 0.74+/- 0.208, while the pre-treatment mean CMT was 609.0 ± 178.29 µm in Group-A, and 600.0 +/- 155.09 µm in Group-B respectively. After 1 month of therapy, the visual status, and CMT in Group-A was 0.29+/- 0.21 and 311.6 +/- 89.9, while Group-B, VA was 0.598 +/- 0.23 (p value 0.001%) and CMT was 512.30 +/- 148.37 (p-value 0.001%). Rifampicin was continued in Group-B till three months, and patients were re-accessed but there was no difference in VA and CMT statically. During the 3rd and 6th months of follow up no relapses were reported. Conclusion: This comparative study showed that the group receiving oral rifampicin 600mg for one month showed better outcome at one month and third month than the group receiving oral rifampicin at a dose of 300mg once daily for three months. This gives a better compliance and lower the risk of drug induced side effects. doi: https://doi.org/10.12669/pjms.35.6.990 How to cite this:Loya H, Ghoghari H, Rizvi SF, Khan A. Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy. Pak J Med Sci. 2019;35(6):1687-1690. doi: https://doi.org/10.12669/pjms.35.6.990 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Macular pigment optical density in central serous chorioretinopathy

2021 ◽  
Vol 13 ◽  
pp. 251584142199719
Author(s):  
Burcu Polat Gultekin ◽  
Esra Sahli
Keyword(s):  
Confidence Interval ◽  
Optical Density ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Retinal Thickness ◽  
Macular Pigment ◽  
Central Retinal Thickness ◽  
Macular Pigment Optical Density ◽  
Chronic Central Serous Chorioretinopathy ◽  
Acute Central Serous Chorioretinopathy

Purpose: The aim of our study was to evaluate the macular pigment optical density in patients with acute and chronic central serous chorioretinopathy and to describe the association between central retinal thickness and choroidal thickness with the macular pigment optical density. Materials and Methods: Eyes with acute central serous chorioretinopathy and chronic central serous chorioretinopathy (patients, who were diagnosed as having disease activity for 6 months) were included in this study. Macular pigment was measured using the heterochromatic flicker technique of the MPS II device for both eyes in patients with acute and chronic central serous chorioretinopathy and in control subjects. Results: Twenty-seven eyes with acute central serous chorioretinopathy, 23 eyes with chronic central serous chorioretinopathy, and 25 control eyes were enrolled. The mean macular pigment optical density in chronic central serous chorioretinopathy (0.480 ± 0.16 density unit (95% confidence interval: 0.390–0.570) was found to be significantly lower than in the control eyes (0.571 ± 0.128 density unit) (95% confidence interval: 0.480–0.670) ( p = 0.007). In correlation analysis, no significant association was detected between the central retinal thickness, choroidal thickness, and macular pigment optical density values in central serous chorioretinopathy group ( p = 0.31, p = 0.71). Conclusion: Macular pigment optical density levels were significantly lower in chronic central serous chorioretinopathy patients than in controls, possibly due to degeneration of the neurosensorial retina, as a result of the long-term persistence of subretinal fluid. There was not a significant correlation between choroidal thickness and macular pigment optical density levels in central serous chorioretinopathy group.

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