| 발표일자: |
2019년 4월 5일(금)~7(일) |
| 발표번호: |
P(e-poster)-256 |
| 발표장소: |
벡스코 전시장 1홀 내 |
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| Efficacy and safety of oral spironolactone for treatment of chronic central serous chorioretinopathy |
| Khon kaen University, Thailand |
| Watcharaporn Thongmee*, MD, Thuss Sanguansak, MD, Chavakij Bhoomibunchoo, MD, Yosanan Yospaiboon, MD, Supat Sinawat, MD, Suthasinee Sinawat, MD |
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Purpose : To compare the efficacy of oral spironolactone treatment versus conservative treatment in patients with chronic central serous chorioretinopathy (CSC).
Methods : Medical records and retinal images of 69 patients with chronic central serous chorioretinopathy (CSC) were reviewed. Twenty-three patients received oral spironolactone (50 mg/day) while 46 patients received conservative treatment. Primary outcome was proportion of eyes with complete resolution of subretinal fluid (SRF). Changes in SRF height, central macular thickness (CMT), ellipsoid layer disruption and best-corrected visual acuity (BCVA) were also assessed.
Results : Sixty-nine patients, 44 men and 25 women, were recruited. Mean age was 44.71±8.94 years and mean follow up time was 5.18±1.34 months. In demographic data, duration of symptoms was significantly longer (p=0.0001) and baseline BCVA was significantly worse in treatment group (p=0.038). Mean duration of spironolactone treatment was 4.95±1.40 months. Complete resolution of SRF were significantly higher in treatment group at 1 month (p=0.001), but not statistically significant at 3 and 6 months. Five eyes (41%) in treatment group and 6 eyes (43%) in control group had recurrence of SRF. However, the overall proportion of eyes with experienced complete resolution of SRF was higher in treatment group (56% vs 35%) (p=0.20). Visual gain, CMT reduction, and ellipsoid layer proliferation were observed in both groups; there were no statistically significant differences between groups. Nevertheless, the improvement 2 lines or more of visual acuity was significantly higher in treatment group (p=0.05). No any side effects of spironolactone were detected.
Conclusion : Spironolactone seems to be beneficial and safe in the treatment of chronic CSC patients. Significant improvement in SRF and CMT was observed. For visual outcome, spironolactone help to restore visual function because it accelerates improvement compared to conservative treatment resulting in better visual outcome. Spironolactone may be an alternative treatment in patients who cannot afford the PDT treatment.
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