scholarly journals Oral Eplerenone Versus Observation in the Management of Acute Central Serous Chorioretinopathy: A Prospective, Randomized Comparative Study

2020 ◽  
Vol 13 (8) ◽  
pp. 170
Author(s):  
Ramesh Venkatesh ◽  
Arpitha Pereira ◽  
Chaitra Jayadev ◽  
Vishma Prabhu ◽  
Aditya Aseem ◽  
...  
Keyword(s):  
Treatment Group ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Control Group ◽  
Symptom Duration ◽  
Imaging Features ◽  
Observation Group ◽  
Fellow Eye ◽  
Beneficial Effects ◽  
Acute Central Serous Chorioretinopathy

In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for <12 weeks duration with no clinical or imaging features of chronicity. Patients were alternately divided into treatment (Table Eplerenone 50 mg/day for minimum 1 month) and observation groups. Vision, SRF height and subfoveal choroidal thickness (SFCT) were checked at 1-, 2- and 3-months in both eyes of each group. Each group had 29 eyes. Mean age was 40.4 ± 7.1 and 43.3 ± 8.34 years in treatment and observation group, respectively. Mean symptom duration was 6.46 ± 1.45 and 5.87 ± 2.09 weeks, respectively. Vision improvement to 6/6 was seen in 92%, 100% and 100% cases in treatment group and 74%, 86% and 100% in control group at each visit, respectively. Complete SRF resolution in the treatment group was noted in 45%, 55% and 62% cases at each respective monthly visit. In the observation group, complete SRF resolution was noted in 10%, 21% and 31% at 1-, 2- and 3-month visits, respectively. SRF (p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye.

scholarly journals Spironolactone versus observation in the treatment of acute central serous chorioretinopathy

2017 ◽  
Vol 102 (8) ◽  
pp. 1060-1065 ◽  
Author(s):  
Xinghong Sun ◽  
Yuanlu Shuai ◽  
Wangyi Fang ◽  
Jia Li ◽  
Weizhong Ge ◽  
...  
Keyword(s):  
Treatment Group ◽  
Central Serous Chorioretinopathy ◽  
Complete Resolution ◽  
Subretinal Fluid ◽  
Control Group ◽  
Significant Difference ◽  
Registration Number ◽  
Acute Central Serous Chorioretinopathy ◽  
The Mean ◽  
Randomised Controlled

PurposeTo evaluate the efficacy of oral spironolactone in patients with acute central serous chorioretinopathy (CSC).MethodsThis is a prospective, randomised controlled clinical study. Thirty patients with acute CSC were the participants, including 18 patients who were treated with spironolactone (40 mg orally, twice daily) for 2 months in the experimental group and 12 patients who received observation in the control group. Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid (SRF), changes in central macular thickness (CMT), the height of SRF (SRFH), best corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT). The follow-up period was 2 months.ResultsComplete resolution of SRF was achieved in 55.6% (10/18) and 8.3% (1/12) of the eyes in the treatment group and the control group, respectively, at 2 months (p=0.018). The mean CMT and SRFH decreased significantly at each visit in both groups (p<0.05), and there was significant difference between the two groups at 2 months (p<0.05 and p<0.05, respectively). BCVA (in logarithm of the minimum angle of resolution; mean) improved in both groups at 2 months (p<0.05). In the treatment group, the mean baseline SFCT significantly decreased from 502.50±87.38 µm to 427.44±74.37 µm at 2 months (p<0.01), while the change from baseline (from 480.33±102.38 µm to 463.75±100.63 µm) was not significant in the control group (p=0.195). But the differences between the two groups in BCVA and SFCT were not significant.ConclusionsOral spironolactone is more effective with a faster absorption of SRF than observations. It is a promising treatment for acute CSC.Trial registration numberChiCTR-IPR-16008428, Results.

Effects of Ketoconazole On Clinical Recovery In Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Yodpong Chantarasorn ◽  
Kochapong Rasmidatta ◽  
Itsara Pokawattana ◽  
Sukhum Silpa-archa
Keyword(s):  
Treatment Group ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Rescue Therapy ◽  
Subretinal Fluid ◽  
Urinary Free Cortisol ◽  
Control Group ◽  
Time Interval ◽  
Day Range ◽  
Free Cortisol

Abstract Background: Hypercortisolism has long been correlated with choroidal vasorelaxation in central serous chorioretinopathy (CSCR). This may explain the inconsistency of therapeutic responses of the mineralocorticoid receptor (MR) antagonist since hyperaldosteronism has rarely been detected in such cases. Hence, an early treatment using ketoconazole, the first line cortisol inhibitor that also blocks the MR ligand, appears to be rational. This study aimed to evaluate the effects of ketoconazole on CSCR, and to analyze correlations between choroidal thickness and steroid hormones.Method: In this three-center retrospective cohort, forty-one naïve CSCR eyes of 41 patients were categorized into control (20 eyes) and treatment group (21 eyes). Patients in the treatment group were given oral ketoconazole at a daily dose of 400 or 600 mg for three to six weeks. At week 12, rescue laser therapy was applied to patients exhibiting persistent subretinal fluid (SRF). We performed a survival analysis to determine the time interval from presentation to clinical resolution of SRF. The secondary outcomes consisted of proportion of eyes with persistent SRF, and factors affecting therapeutic response.Results: Mean 24-hour urinary free cortisol (UFC) were elevated at 181 ± 70 and 150 ± 68 µg/day (range = 20-150) in the treatment and control group (p = 0.21). After controlling for age and gender, baseline UFC levels demonstrated a positive correlation with choroidal thickness in both eyes (p < 0.05). Ketoconazole significantly accelerated the resolution of CSCR with the median time to resolution of 7 versus 16 weeks (p < 0.01), and reduced the proportion of eyes receiving rescue therapy at 12 weeks (23.8% versus 50%, p = 0.01). Prolonged CSCR durations were likely found in elderly patients who had thick choroid in fellow eyes.Conclusions: Elevated glucocorticoids are likely responsible for the pathogenesis of CSCR. Therefore, a temporary decrease in choroidal hyperpermeability using the cortisol blocker could reduce the persistency of CSCR.

scholarly journals Pattern of Contrast Sensitivity Changes in Acute Central Serous Chorioretinopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Preeyachan Lourthai ◽  
Patama Bhurayanontachai
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Contrast Sensitivity ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Spontaneous Resolution ◽  
Fellow Eye ◽  
Spatial Frequencies ◽  
Acute Central Serous Chorioretinopathy ◽  
Sensitivity Changes

Purpose. To evaluate contrast sensitivity (CS) changes in acute central serous chorioretinopathy (CSC). Methods. Visual acuity (VA), CS, and subretinal fluid (SRF) were evaluated monthly for 6 months. Treatment was considered at 3 months in case of persistent SRF. Results. Twelve of 20 eyes (60%) had spontaneous SRF resolution within 4 months. Five of 8 patients with delayed SRF resolution received either focal laser or photodynamic therapy. The CS was impaired in all spatial frequencies at baseline. There was a negative correlation between the baseline SRF thickness and CS at 3 and 6 cycles per degree (cpd). The CS improved significantly at the time of fluid resolution (p=0.001) and continued to improve in 3 and 6 cpd. The CS at 6 cpd did not recover if compared to a normal fellow eye at 6 months (p=0.018). The CS of 12 cpd at 6 months was superior in the spontaneous resolution group. Conclusion. The impaired CS gradually improved as the SRF reduced at all spatial frequencies. CS at 3 and 12 cpd continued to improve after complete fluid resolution. Despite an excellent final VA, the CS at 6 months did not regain its normal value.

scholarly journals Choriocapillaris Ischemia at the Leakage Point of Patients With Acute Central Serous Chorioretinopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Zuofen Wang ◽  
Zhaoting Xin ◽  
Jun Yang ◽  
Huawen Lu ◽  
Haiying Wang ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Density Ratio ◽  
Subretinal Fluid ◽  
Recovery Process ◽  
Vessel Density ◽  
Control Group ◽  
Fundus Fluorescein Angiography ◽  
Acute Central Serous Chorioretinopathy ◽  
The Mean ◽  
Tomographic Angiography

Purpose: We aimed to determine ischemia of the choriocapillaris at the leakage point of patients with acute central serous chorioretinopathy (CSC) by optical coherence tomographic angiography (OCTA).Methods: A retrospective study of 38 eyes of 38 acute CSC patients with spontaneous complete resolution of subretinal fluid (SRF) was conducted and patients were followed for 3 months. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed at baseline. Best corrected visual acuity (BCVA) and OCTA were collected at baseline and at follow-up visits. An age- and refractive error-matched control group consisted of 40 eyes of 40 healthy people.Results: The BCVA of patients significantly improved at 1 and 3 months. At baseline, all eyes showed a decreased choriocapillaris vessel density. The mean vessel density of superficial choroid (VDSC) at the leakage point area was 44.18 ± 9.27, which increased to 54.31 ± 9.70 at 1 month (p &lt; 0.001) and to 55.19 ± 6.46 at 3 months (p &lt; 0.001). The mean vessel density ratio was 0.90 ± 0.16 at baseline, which increased to 0.96 ± 0.15 at 1 month (p = 0.037) and to 0.97 ± 0.08 at 3 months (p = 0.016). The highest VDSC of patients was lower than that of normal control (p &lt; 0.001).Conclusions: The VDSC at the leakage point of acute CSC patients was significantly thinner and regularly increased with the recovery process, which suggested that ischemia might be one of the initiating factors in the pathogenesis of acute CSC.

scholarly journals Selective Retina Therapy with Real-Time Feedback-Controlled Dosimetry for Treating Acute Idiopathic Central Serous Chorioretinopathy in Korean Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ye Ji Kim ◽  
Youn Gon Lee ◽  
Dong Won Lee ◽  
Jae Hui Kim
Keyword(s):  
Real Time ◽  
Central Serous Chorioretinopathy ◽  
Therapeutic Option ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Short Term Treatment ◽  
Foveal Thickness ◽  
Clinical Trial Registration ◽  
Korean Patients ◽  
Selective Retina Therapy

Purpose. To evaluate short-term treatment outcomes following selective retina therapy (SRT) with real-time feedback-controlled dosimetry in Korean patients with acute idiopathic central serous chorioretinopathy (CSC). Methods. Sixteen eyes (16 patients) with acute idiopathic CSC (symptom duration < 3 months) were included in this retrospective study. All patients underwent a single session of SRT with real-time feedback-controlled dosimetry. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) before and 3 months after treatment were examined and compared. Results. The logarithm of minimal angle of resolution BCVA was significantly better 3 months after treatment (0.16 ± 0.18) than at the time of diagnosis (0.27 ± 0.18, P=0.002). Additionally, subretinal fluid had resolved in all 16 eyes 3 months after treatment and CFT was significantly lower 3 months after treatment (215.6 ± 17.9 μm) than at baseline (441.4 ± 124.8 μm, P<0.001). No notable SRT-related complications were observed during the study period. Conclusion. The results of the present study suggest that SRT is a useful therapeutic option for patients with acute idiopathic CSC. Further studies are required to better understand the long-term efficacy of this treatment. This trial is registered with clinical trial registration number NCT03339856.

scholarly journals Evaluation of acute central serous chorioretinopathy using enhanced depth imaging OCT and multifocal electroretinography

2020 ◽  
Author(s):  
In Hwan Hong ◽  
In Boem Chang ◽  
Jae Ryong Han
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Multifocal Electroretinography ◽  
Enhanced Depth Imaging ◽  
Implicit Time ◽  
Depth Imaging ◽  
Acute Central Serous Chorioretinopathy ◽  
Normal Controls

Abstract Background To evaluate the functional and structural abnormalities in patients with acute central serous chorioretinopathy (CSC) by multifocal electroretinography (mfERG) and enhanced depth imaging optical coherence tomography (EDI-OCT) Methods This prospective observational study included 57 patients with unilateral CSC. Both eyes underwent mfERG and EDI-OCT. Peak amplitudes and implicit times of the first kernel responses were analyzed and compared with those in 25 age-matched normal controls. Correlational analyses were performed between the mfERG results and EDI-OCT parameters. The thicknesses of the central retina, subretinal fluid, and choroid was measured at baseline and 3 months later. Results Compared with the normal controls, the amplitude and implicit time on mfERG were significantly impaired in the area with serous retinal detachment (SRD). The P1 amplitude and implicit time of the areas beyond the SRD were also found to be significantly impaired in the affected eyes. Eyes with a greater reduction in SRD had a less impaired mfERG response in fellow eyes than those whose retinal detachments were not spontaneously decreased by more than 90% after 3 months. Correlational analysis did not reveal any significant correlations between mfERG values and OCT parameters except for central choroidal thickness. The subfoveal choroidal thickness was negatively correlated with the mfERG parameters. Conclusion The findings of this study indicate diffuse functional impairment in acute CSC which involves both eyes and areas beyond the SRD. The retinal response of the unaffected eye was associated with regression of SRD and functional retinal abnormality is correlated with pathological changes in the choroid.

Treatment of Lung Cancer Complicated with Infection of Talaromyces Marneffei Based on Chest Imaging Characteristics Monitoring (Preprint)

2020 ◽  
Author(s):  
Yiling Feng ◽  
Xiaoping Li ◽  
Yanqin Wang ◽  
Shar Lenepe
Keyword(s):  
Lung Cancer ◽  
Control Group ◽  
Imaging Features ◽  
Observation Group ◽  
Chest Imaging ◽  
Lung Cancer Patients ◽  
Talaromyces Marneffei ◽  
Imaging Characteristics ◽  
Strip Shape ◽  
Male Patients

BACKGROUND Background: At present, although the infection of Talaromyces Marneffei has been known at home and abroad, there are few reports of Talaromyces Marneffei in lung cancer. OBJECTIVE Objective: The objective is to explore the diagnosis and treatment process of lung cancer patients with infection of Talaromyces Marneffei and its chest imaging characteristics, so as to improve the clinicians' realization of the disease. METHODS Method: The patients with lung cancer and infection of Talaromyces Marneffei (observation group) and the patients with infection of Talaromyces Marneffei (control group) are taken as the study objects, and the clinical characteristics and chest CT (computed tomography) imaging characteristics of the two groups are compared and summarized. RESULTS Results: The number of male patients infected with Talaromyces Marneffei is significantly higher than that of female patients (P < 0.05). The symptoms of cough and expectoration in the observation group are more than those in the control group (P < 0.05). The main imaging features of the observation group are obvious enhancement of focus enhancement scanning, strip shape and nodule, and the situation of obvious enhancement of focus enhancement scanning in the observation group is significantly higher than that in the control group (P < 0.05). CONCLUSIONS Conclusion: The clinical and imaging features of lung cancer and Talaromyces Marneffei infection overlap. When the lung lesions of patients with Talaromyces Marneffei have significant malignant signs, the possibility of lung cancer should be considered.

Clinical Analysis of Qinglongdingchuan Decoction on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 7 (5) ◽  
pp. 1357-1364
Author(s):  
Xiujiang Wang ◽  
Bo Yang ◽  
Rui Shi ◽  
Lixiu Zhang
Keyword(s):  
Treatment Group ◽  
Clinical Symptoms ◽  
Blood Gas Analysis ◽  
Effective Rate ◽  
Gas Analysis ◽  
Inflammatory Factors ◽  
Control Group ◽  
Chronic Obstructive ◽  
Observation Group ◽  
Obstructive Pulmonary Disease

Objective To explore the clinical effect of QinglongDingchuan Decoction on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze its mechanism. Methods From June 2017 to June 2019, patients with AECOPD were randomly divided into the observation group and the control group according to the time sequence of treatment, 40 cases in each group were observed. Control group: conventional western medicine treatment (controlled oxygen therapy, antibiotics, expectorants, bronchodilators, etc.), observation group: QinglongDingchuan decoction. 6 days is a course of observation. The routine pulmonary function, blood gas analysis, serum inflammatory factors, clinical symptoms and signs were observed. Results The observation group was superior to the control group in clinical control rate and effective rate (P < 0.05), suggesting that the treatment group was superior to the control group in overall effective rate. There were differences in symptoms, physical signs and total symptom scores between the two groups before and after treatment. The improvement of serum inflammatory factors in the treatment group was better than that in the control group. The improvement of PaC02 and Pa02 in the treatment group was better than that in the control group. Conclusion QinglongDingchuan decoction can better improve the clinical symptoms, physical signs, blood gas analysis indicators, improve the overall efficiency, and has a better effect on patients with fever AECOPD.

scholarly journals Mineralocorticoid Receptor Antagonist Treatment for Steroid-Induced Central Serous Chorioretinopathy Patients with Continuous Systemic Steroid Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jin Young Kim ◽  
Ju Byung Chae ◽  
Jisoo Kim ◽  
Dong Yoon Kim
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Complete Resolution ◽  
Mineralocorticoid Receptor ◽  
Therapeutic Option ◽  
Subretinal Fluid ◽  
Primary Outcome Measure ◽  
Electrolyte Imbalance ◽  
Systemic Steroid ◽  
Symptom Duration ◽  
Mineralocorticoid Receptor Antagonist

Purpose. To investigate the effectiveness of mineralocorticoid receptor (MR) antagonist in patients with steroid-induced central serous chorioretinopathy (CSC). Methods. A retrospective review was conducted of steroid-induced CSC patients who were treated with the MR antagonist spironolactone 50 mg once per day for at least 1 month. The primary outcome measure was complete resolution rate of subretinal fluid (SRF) after spironolactone treatment. Secondary outcomes included central subfield thickness (CST), subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) changes after spironolactone treatment. Results. Seventeen eyes from 15 patients were included in this study. Conditions warranting chronic systemic steroid use were myasthenia gravis (6/15, 40%), glomerulonephritis (5/15, 33.3%), and organ transplantation (4/15, 26.7%). Mean symptom duration of CSC was 4.00 ± 3.04 months. After spironolactone treatment, 14 eyes (82.4%) showed complete resolution of SRF (P<0.001) without discontinuation of systemic steroid. CST and BCVA were significantly improved after spironolactone treatment. SFCT was significantly decreased after spironolactone treatment. No patients experienced electrolyte imbalance after spironolactone treatment. Conclusion. MR antagonist treatment may be a therapeutic option for steroid-induced CSC patients. This treatment modality may be especially beneficial for steroid-induced CSC patients who cannot discontinue steroid medication due to systemic conditions.

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