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Yahalomi T, Pikkel YS, Arnon R, Kinori M, Wood K, Pikkel J. Acute Central Serous Chorioretinopathy Outbreak during the COVID-19 Pandemic: A Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:122. [PMID: 38256383 PMCID: PMC10818957 DOI: 10.3390/medicina60010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: This study aims to investigate the potential association between the COVID-19 pandemic and a new presentation of central serous chorioretinopathy (CSCR). Materials and Methods: A retrospective analysis was conducted, comparing the incidence of new-onset CSCR cases among ophthalmology patients in a regional medical facility in southern Israel between two distinct periods: the COVID-19 pandemic era in Israel, which occurred from 27 February 2020 to 20 December 2020, and the non-pandemic period from calendar years 2018 to 2021, excluding the specific epidemic phase mentioned. Disease severity was evaluated based on recovery time, visual acuity loss, and central macular thickness via OCT. Results: Over the four-year period, 35 new cases of CSCR were recorded. During the COVID-19 pandemic, 17 new cases (0.005% per population) were identified, compared with 18 new cases (0.002% per population) in the preceding three years. The odds ratio for acute CSCR during the pandemic was 2.83 (95% CI, 1.46-5.50) with a p-value of 0.02. CSCR cases during the pandemic seemed to exhibit worse clinical characteristics, though not statistically significant. Additionally, 22.2% of the COVID-19 pandemic group had confirmed COVID-19 cases, which was statistically significantly higher than the general population's reported cases (6%). Conclusion: The study revealed a statistically significant increase of over 2.5 times in acute CSCR incidence during the COVID-19 pandemic compared with non-pandemic periods. The findings suggest that the pandemic's stressful changes may have unintended consequences on the occurrence of CSCR, highlighting the importance of mental health support and psychoeducation for affected patients.
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Affiliation(s)
- Tal Yahalomi
- Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (R.A.); (M.K.); (K.W.); (J.P.)
| | - Yael Sara Pikkel
- Rambam Health Care Campus and Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
| | - Roee Arnon
- Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (R.A.); (M.K.); (K.W.); (J.P.)
| | - Michael Kinori
- Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (R.A.); (M.K.); (K.W.); (J.P.)
| | - Keren Wood
- Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (R.A.); (M.K.); (K.W.); (J.P.)
| | - Joseph Pikkel
- Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (R.A.); (M.K.); (K.W.); (J.P.)
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Seraj H, Alhamoud M, Khoshhal MS, Alhashim H, Alsaif A, Abukhashabah A. The Uses of Photodynamic Therapy Versus Anti-vascular Endothelial Growth Factor in the Management of Acute Central Serous Chorioretinopathy: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e46100. [PMID: 37900481 PMCID: PMC10611943 DOI: 10.7759/cureus.46100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Central serous chorioretinopathy (CSCR) is an idiopathic chorioretinal disease characterized by localized serous detachment of the neurosensory retina at the macula. To date, there is no high-quality evidence of recent updates on treating acute CSCR, focusing on photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF). Hence, this review aims to conduct a comprehensive systematic review of the most recent therapeutic approaches for acute CSCR using the following electronic databases for a comprehensive and systematic literature review: MEDLINE, EMBASE, and Cochrane. In addition, we analyzed studies comparing PDT with placebo, anti-VEGF with placebo, or PDT with anti-VEGF in treating acute CSC eyes with no previous intervention. Seven studies were included, with a total of 292 eyes. The overall positive results were significantly higher among patients who received PDT compared to control groups (odds ratio [OR] = 7.96, 95% confidence interval [CI], 3.02 to 20.95, p < 0.001). The proportions of positive results were 81.0% and 97.1% among patients who received anti-VEGF and PDT, respectively, with no statistically significant differences between the groups. In addition, there were no significant differences between anti-VEGF and control groups. In contrast, PDT was significantly associated with lower recurrence odds than the control groups (OR = 0.12, 95% CI, 0.04 to 0.39, p = 0.042). According to our findings, PDT showed higher positive results than anti-VEGF in acute CSCR. In addition, PDT was significantly associated with a lower recurrence rate than the control group. However, the analysis needs to be confirmed and updated by large-scale, well-designed randomized clinical trials.
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Affiliation(s)
- Hadeel Seraj
- Department of Ophthalmology, King Abdulaziz University, Jeddah, SAU
| | - Mustafa Alhamoud
- Department of Ophthalmology, King Fahd Hospital of the University, Dammam, SAU
| | | | - Hassan Alhashim
- Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Anas Alsaif
- College of Medicine, King Saud University, Riyadh, SAU
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Ilhan C, Citirik M, Özdemir M. Non-damaging retinal laser therapy in chronic central serous chorioretinopathy. Int Ophthalmol 2023; 43:2875-2882. [PMID: 36971927 DOI: 10.1007/s10792-023-02691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To investigate the functional and anatomical outcomes of non-damaging retinal laser therapy (NRT), in cases with chronic central serous chorioretinopathy (CSCR). METHODS Twenty-three eyes of 23 treatment-naïve chronic CSCR patients were included in this study. The irradiation of 577 nm yellow light was conducted on the serous detachment area after switching over to the NRT algorithm. Anatomical and functional changes after treatments were investigated. RESULTS The mean age of the subjects was 48.68 ± 5.93 years (41-61). The mean best-corrected visual acuity (BCVA) and the mean central macular thickness (CMT) values were 0.42 ± 0.12logMAR (0.20-0.70) and 315.69 ± 61.25 µm (223-444) before NRT; and 0.28 ± 0.11logMAR (0.10-0.50) and 223.26 ± 60.91 µm (134-336) at the 2nd month follow-up visit (p < 0.001, for both). At the 2nd-month follow-up visit after NRT, complete resorption of subretinal fluid was observed in 18 eyes (78.3%) and incomplete resorption in five eyes (21.7%). Worse values of BCVA and CMT before NRT were found as increased risk for incomplete resorption (p = 0.002 and ρ = 0.612 for BCVA, and p < 0.001 and ρ = 0.715 for CMT). CONCLUSION Significant functional and anatomical improvements can be observed in the early period after NRT in patients with chronic CSCR. Patients having worse baseline BCVA and CMT have increased risk for incomplete resorption.
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Affiliation(s)
- Cagri Ilhan
- Department of Ophthalmology, Tayfur Ata Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Merkez Mah. Tayfur Sokmen Cad. No: 36, 31080, Antakya/Hatay, Turkey.
| | - Mehmet Citirik
- Department of Ophthalmology, University of Health Sciences, Etlik City Education and Research Hospital, Ankara, Turkey
| | - Mesut Özdemir
- Department of Ophthalmology, University of Health Sciences, Etlik City Education and Research Hospital, Ankara, Turkey
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Zhang X, Lim CZF, Chhablani J, Wong YM. Central serous chorioretinopathy: updates in the pathogenesis, diagnosis and therapeutic strategies. EYE AND VISION (LONDON, ENGLAND) 2023; 10:33. [PMID: 37430344 DOI: 10.1186/s40662-023-00349-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/12/2023] [Indexed: 07/12/2023]
Abstract
Central serous chorioretinopathy (CSCR), first described by Albrecht von Graefe in 1866, is characterized by focal serous detachment of the neural retina and/or retinal pigment epithelium (RPE) in the posterior pole. CSCR is the first ever described pachychoroid disease. Most recently, hypothetical venous overload choroidopathy is also proposed due to its distinguished morphological and pathological characteristics, including choroidal thickening, choriocapillaris hyperpermeability, remodelling, and intervortex venous anastomoses. Identification of genetic variants is necessary to comprehend the pathophysiology of CSCR. The novel multimodality imaging platforms, including the ultra-widefield imaging system, flavoprotein fluorescence, fluorescence lifetime imaging ophthalmoscopy, and multispectral imaging system, have been used for diagnosing and managing CSCR. Half-dose photodynamic therapy (PDT) remains the mainstay of clinical practice, with about 95% of patients with chronic CSCR improving to visual acuity (VA) of 20/30 or better. The use of oral eplerenone for routine clinical care remains controversial, and long-term randomized clinical trials are warranted to investigate its efficacy in acute and chronic CSCR. While CSCR has generally been recognized as a self-limiting disease with good prognosis, the underlying pathogenesis is still not fully understood, and treatments are often not fully effective. With new evidence emerging about pachydrusen being a disease precursor in both CSCR and polypoidal choroidal vasculopathy (PCV), it would be interesting to investigate whether CSCR can be a precursor to PCV. In this review, we highlighted the currently available evidence on the pathogenesis, diagnosis, multimodality imaging features, and management strategies, including recent findings related to CSCR.
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Affiliation(s)
- Xinyuan Zhang
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Tongren Hospital, Capital Medical University, Beijing University of Medical Science, Beijing, 100730, People's Republic of China.
| | - Connie Zhi Fong Lim
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Tongren Hospital, Capital Medical University, Beijing University of Medical Science, Beijing, 100730, People's Republic of China
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, USA
| | - Yew Meng Wong
- Southern Specialist Eye Center SDN, BHD, Malacca, Malaysia
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Comparison of the fluorescein angiography-guided and indocyanine green angiography-guided photodynamic therapy in the treatment of non-resolving central serous chorioretinopathy. Sci Rep 2023; 13:1682. [PMID: 36717729 PMCID: PMC9886924 DOI: 10.1038/s41598-023-28890-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
To compare the functional and anatomical outcome of fluorescein angiography (FA) versus indocyanine green angiography (ICGA) guided photodynamic therapy (PDT) in the treatment of non-resolving central serous chorioretinopathy (CSCR). In this prospective interventional case series, all patients with non-resolving CSCR, defined as persistent SRF involving subfoveal area for at least three months, were nonrandomly assigned to receive either FA or ICGA-guided half dose PDT. Baseline and 4 months post-treatment data including best corrected visual acuity (BCVA), the status of foveal subretinal fluid, subfoveal choroidal thickness, choroidal vascularity index, pigment epithelial detachment area, treatment and PDT spot numbers were collected. Thirty-six eyes were included; 24 received ICGA-guided and 12 received FA-guided PDT. Overall, improvement in BCVA and choroidal parameters were observed in all patients. There was no significant difference in baseline parameters as well as follow-up measurements between groups. However, the mean total energy dose and spot number in the IGCA-guided PDT were significantly higher than the FA-guided PDT group (P = 0.001). Both FA-guided and ICGA-guided half-dose PDT were effective in the treatment of non-resolving CSCR, with favorable functional and anatomical outcome. In FA group, PDT with smaller spot sizes and fewer numbers of spots were applied.
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Zarnegar A, Ong J, Matsyaraja T, Arora S, Chhablani J. Pathomechanisms in central serous chorioretinopathy: A recent update. Int J Retina Vitreous 2023; 9:3. [PMID: 36670451 PMCID: PMC9854068 DOI: 10.1186/s40942-023-00443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Central serous chorioretinopathy (CSCR) is a potentially blinding choroidal disease. Despite decades of research, the pathological mechanisms of CSCR are still poorly understood. In recent years, there has been a strong emphasis on choroidal dysfunction as a primary cause of CSCR. MAIN BODY The concept of the pachychoroid disease spectrum and pachychoroid-driven processes are central to current theories regarding the pathophysiological underpinnings of CSCR. Choroidal hyperpermeability and subsequent leakage of fluid seen in CSCR may be due to several causes. Among them are venous congestion, inflammation, mineralocorticoid receptor activation, systemic factors including hemodynamic changes, obstructive sleep apnea, phosphodiesterase inhibitor use, pregnancy, and genetic predispositions. Congestion of vortex veins that drain blood from the choroid may contribute to the dilation of Haller vessels and cause fluid leakage. Vortex veins exit the eye through the sclera; thus, increased scleral thickness has been proposed to be a factor in venous congestion. Asymmetric vortex vein drainage may similarly result in congestion of the local venous system. Vortex vein anastomoses may overload the venous system and form secondary to venous congestion. Recent studies suggest inflammation and mineralocorticoid activation may factor into the development of CSCR, though more research in these areas is called for. Systemic conditions and genetics may predispose individuals to develop CSCR. CONCLUSIONS By striving to understand the molecular and physiological mechanisms of this disease, we can better diagnose and treat CSCR to improve outcomes for patients.
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Affiliation(s)
- Arman Zarnegar
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Joshua Ong
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | | | - Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau, NP Bahamas
| | - Jay Chhablani
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
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Gar'kavenko VV, Salmin VV, Balashova PM, Gaydelis VS, Kokozova DS. [Spectrofluorimetric changes in the lens after intravitreal injections of brolucizumab]. Vestn Oftalmol 2023; 139:41-49. [PMID: 38235629 DOI: 10.17116/oftalma202313906141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Intravitreal injections (IVI) of vascular endothelial growth factor (VEGF) inhibitors are actively used in the treatment of various ophthalmic pathologies. In addition to the pronounced therapeutic effect of anti-VEGF drugs described in the literature, a number of data on adverse effects associated with the use of IVI, including from the lens, have now been accumulated. Prevention of possible side effects of this type of treatment requires further investigation. PURPOSE The study evaluates the changes in spectrofluorometric parameters of the lens after intravitreal injections of brolucizumab in eyes with native lens. MATERIAL AND METHODS The study included 13 people with neovascular age-related macular degeneration (AMD) who received IVI of brolucizumab. All patients were over 40 years old; changes in central retinal thickness in the macular area exceeded 300 μm according to optical coherence tomography. Spectrofluorimetric indicators of the lens were studied before and after injections of the drug in both eyes. The spectra were analyzed in the wavelength range 412-698 nm to record the changes in the content of non-tryptophan fluorophore molecules in the lens. RESULTS Spectrofluorimetry revealed metabolic changes in the native lens after intravitreal injections of the drug brolucizumab. No such changes were observed in the lens of the eyes not injected with the drug (the «Control» group). The proposed investigation technique involves prospective assessment of the safety of various molecules injected intravitreally in terms of cataract development at various times after the injection. CONCLUSION Spectrofluorimetry can be used for identifying initial metabolic changes in the lens. It is a promising method for assessing the molecules used in intravitreal injections in terms of their safety for the native lens, as well as for development of detailed instructions for clinically substantiated use of drugs with adverse effects in the form of cataract induction. According to spectrofluorimetry, IVI of the drug brolucizumab affects metabolic changes in the lens.
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Affiliation(s)
- V V Gar'kavenko
- Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov, Krasnoyarsk, Russia
| | - V V Salmin
- National Research Nuclear University «MEPhI» (Moscow Engineering Physics Institute), Moscow, Russia
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudniy, Russia
- Moscow State Technical University named after N.E. Bauman (National Research University), Moscow, Russia
| | - P M Balashova
- Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov, Krasnoyarsk, Russia
- Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky, Krasnoyarsk, Russia
| | - V S Gaydelis
- Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov, Krasnoyarsk, Russia
| | - D S Kokozova
- Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov, Krasnoyarsk, Russia
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Park JB, Kim K, Kang MS, Kim ES, Yu SY. Central serous chorioretinopathy: Treatment. Taiwan J Ophthalmol 2022; 12:394-408. [PMID: 36660123 PMCID: PMC9843567 DOI: 10.4103/2211-5056.362040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Central serous chorioretinopathy (CSC) is a pachychoroid spectrum disease characterized by serous detachment of the neurosensory retina with subretinal fluid in young and middle-aged adults. The pathogenesis of CSC is not yet fully understood. However, it is considered a multifactorial disease that is strongly associated with choroidal dysfunction or vascular engorgement. Although there is no consensus on the treatment of CSC, photodynamic therapy has been effectively used to manage serous retinal detachment (SRD) in CSC. Moreover, micropulse diode laser photocoagulation and focal laser treatment have also been used. Recently, oral medications, including mineralocorticoid receptor antagonists, have been proposed for the management of CSC. Multimodal imaging plays a significant role in the diagnosis and treatment of CSC. Optical coherence tomography angiography (OCTA) has the advantage of detecting vascular flow in the retina and choroid layer, allowing for a better understanding of the pathology, severity, prognosis, and chronicity of CSC. In addition, early detection of choroidal neovascularization in CSC is possible using OCTA. This review article aims to provide a comprehensive and updated understanding of CSC, focusing on treatment.
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Affiliation(s)
- Jong Beom Park
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Min Seok Kang
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea,Address for correspondence: Prof. Seung-Young Yu, Department of Ophthalmology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-Gu, Seoul 02447, Korea. E-mail:
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Sappa LB, Okuwobi IP, Li M, Zhang Y, Xie S, Yuan S, Chen Q. RetFluidNet: Retinal Fluid Segmentation for SD-OCT Images Using Convolutional Neural Network. J Digit Imaging 2021; 34:691-704. [PMID: 34080105 PMCID: PMC8329142 DOI: 10.1007/s10278-021-00459-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/03/2020] [Accepted: 04/29/2021] [Indexed: 11/25/2022] Open
Abstract
Age-related macular degeneration (AMD) is one of the leading causes of irreversible blindness and is characterized by fluid-related accumulations such as intra-retinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (PED). Spectral-domain optical coherence tomography (SD-OCT) is the primary modality used to diagnose AMD, yet it does not have algorithms that directly detect and quantify the fluid. This work presents an improved convolutional neural network (CNN)-based architecture called RetFluidNet to segment three types of fluid abnormalities from SD-OCT images. The model assimilates different skip-connect operations and atrous spatial pyramid pooling (ASPP) to integrate multi-scale contextual information; thus, achieving the best performance. This work also investigates between consequential and comparatively inconsequential hyperparameters and skip-connect techniques for fluid segmentation from the SD-OCT image to indicate the starting choice for future related researches. RetFluidNet was trained and tested on SD-OCT images from 124 patients and achieved an accuracy of 80.05%, 92.74%, and 95.53% for IRF, PED, and SRF, respectively. RetFluidNet showed significant improvement over competitive works to be clinically applicable in reasonable accuracy and time efficiency. RetFluidNet is a fully automated method that can support early detection and follow-up of AMD.
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Affiliation(s)
- Loza Bekalo Sappa
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China
| | - Idowu Paul Okuwobi
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China
| | - Mingchao Li
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China
| | - Yuhan Zhang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China
| | - Sha Xie
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, 210094, China.
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Chung YR, Kim JW, Song JH, Park A, Kim MH. TWELVE-MONTH EFFICACY OF INTRAVITREAL BEVACIZUMAB INJECTION FOR CHRONIC, ATYPICAL, OR RECURRENT CENTRAL SEROUS CHORIORETINOPATHY. Retina 2020; 39:134-142. [PMID: 29077604 DOI: 10.1097/iae.0000000000001917] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate intravitreal bevacizumab (IVB) injection efficacy for the treatment of chronic, atypical, or recurrent central serous chorioretinopathy (CSC). METHODS Clinical data from 77 eyes of 71 patients with chronic, atypical, or recurrent CSC treated with IVB were retrospectively analyzed. After initial 6-weekly IVB administration until no subretinal fluid remained at the fovea, additional as-needed IVBs were administered, based on optical coherence tomography findings. Best-corrected visual acuity and central retinal thickness (CRT) were analyzed at baseline and 3, 6, 9, and 12 months after initial IVB. RESULTS The significant improvement of baseline logarithm of minimum angle of resolution best-corrected visual acuity and CRT at 3 months (both P < 0.001) was maintained throughout the 12-month follow-up period. Best-corrected visual acuity improved significantly in patients with chronic and recurrent CSC, at all time points (all P < 0.05), but not in patients with atypical CSC. The CRT reduction was significant in all subgroups during the follow-up period (all P < 0.05). Definite leakage on initial fluorescein angiography correlated with improved reduction in CRT (P = 0.039). CONCLUSION As-needed optical coherence tomography-based IVB was effective for reducing CRT in patients with chronic, atypical, or recurrent CSC, and for vision improvement in chronic and recurrent CSC over the 1-year follow-up period.
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Affiliation(s)
- Yoo-Ri Chung
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jong Wan Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ji Hun Song
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Aram Park
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Min Ho Kim
- Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, Republic of Korea
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Bahadorani S, Maclean K, Wannamaker K, Chu ER, Gresores N, Sohn JH, Diaz-Rohena R, Singer MA. Treatment of central serous chorioretinopathy with topical NSAIDs. Clin Ophthalmol 2019; 13:1543-1548. [PMID: 31616132 PMCID: PMC6699520 DOI: 10.2147/opth.s202047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/04/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Central serous chorioretinopathy (CSCR) is a common retinopathy that is often observed until resolution. The purpose of this study is to evaluate the effects of topical nonsteroidal anti-inflammatory drugs (NSAIDs) on timing of CSCR recovery. Methods An IRB-approved retrospective review was conducted on patients that had been diagnosed with a new-onset, symptomatic case of CSCR. Patients were either observed only (13 untreated eyes) or treated with topical bromfenac or nepafenac (14 eyes) over an average of about a 4-5 week follow-up period. Results There was no statistical significance between central macular thickness (CMT) and visual acuity of treatment and control groups at the initial presentation. However, at the follow-up visit, CMT reductions in the treatment group were significantly higher than in the control group (p<0.006). Conclusion Use of topical NSAIDs in the treatment of acute CSCR leads to a faster rate of reduction in the subretinal fluid volume over a follow-up period of a few weeks.
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Affiliation(s)
- Sepehr Bahadorani
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kyle Maclean
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kendall Wannamaker
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Edward Rickie Chu
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nathan Gresores
- Medical Center Ophthalmology Associates, San Antonio, TX, USA
| | - Jeong-Hyeon Sohn
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Roberto Diaz-Rohena
- Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Afanasyeva MA, Budzinskaya MV, Plyukhova AA. [Current understanding of pachychoroid spectrum diseases]. Vestn Oftalmol 2019; 135:293-298. [PMID: 31691675 DOI: 10.17116/oftalma2019135052293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pachychoroid spectrum diseases (the prefix 'pachy-' means 'thick') were proposed as the term indicating an abnormal increase in choroidal thickness, dilatation of choroid vessels and other structural changes in choroid architecture. Pachychoroid spectrum diseases include central serous chorioretinopathy, polypoidal choroidal vasculopathy, pachychoroid pigment epitheliopathy, focal choroidal excavation, pachychoroid neovasculopathy, peripapillary pachychoroid syndrome. Studying the new group of diseases associated with pachychoroid phenotype is a topical task in modern ophthalmology. The emergence of new diagnostic methods such as OCT with angiography mode allows detailed study of this disease group, helps determine the prognosis and choose the tactic for management of these patients.
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Affiliation(s)
- M A Afanasyeva
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - M V Budzinskaya
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Plyukhova
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
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Rodríguez FJ, Staurenghi G, Gale R. The role of OCT-A in retinal disease management. Graefes Arch Clin Exp Ophthalmol 2018; 256:2019-2026. [PMID: 30175386 PMCID: PMC6208724 DOI: 10.1007/s00417-018-4109-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/25/2018] [Accepted: 07/26/2018] [Indexed: 01/18/2023] Open
Abstract
Optical coherence tomography angiography (OCT-A) is a non-invasive, non-dye-based imaging modality that has the potential to enhance our understanding of retinal diseases. While this rapidly advancing imaging modality offers great potential, there is a need for community-wide understanding of the range of technologies and methods for interpreting the images, as well as a need to enhance understanding of images from disease-free eyes for reference when screening for retinal diseases. Importantly, clinical trials have been designed without OCT-A-based endpoints; therefore, caution is required when making treatment decisions based on OCT-A imaging alone. With this in mind, a full understanding of the advantages and limitations of OCT-A will be vital for effective development of the technique within the field of ophthalmology. On behalf of the Vision Academy Steering Committee (sponsored by Bayer), this publication summarizes the views of the authors on the current use of OCT-A imaging and explores its potential for future applications in research and clinical practice.
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Affiliation(s)
- Francisco J Rodríguez
- Fundación Oftalmológica Nacional, Calle 50, #13-50, Bogotá, Colombia. .,Department of Ophthalmology, University of Rosario School of Medicine, Bogotá, Colombia.
| | - Giovanni Staurenghi
- University Eye Clinic, Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - Richard Gale
- Department of Ophthalmology, York Teaching Hospital NHS Foundation Trust, York, UK.,Department of Health Sciences, University of York, York, UK
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Manayath GJ, Ranjan R, Karandikar SS, Shah VS, Saravanan VR, Narendran V. Central serous chorioretinopathy: Current update on management. Oman J Ophthalmol 2018; 11:200-206. [PMID: 30505108 PMCID: PMC6219318 DOI: 10.4103/ojo.ojo_29_2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Central serous chorioretinopathy (CSC), the fourth most common nonsurgical retinopathy with a usual self-limiting course, is known to present with persistent or recurrent form with distressing visual loss. Evolution of newer mutimodal imaging techniques have revolutionized the understanding about the pathophysiology of CSC, and hence the diagnosis and management. Multifactorial etiopathology of CSC promotes the use of multiple treatment modalities. With advances in investigative options, treatment options including conventional focal laser, micropulse laser, photodynamic therapy, and transpupillary thermotherapy are also advancing and refining. Medical management for CSC is also under evaluation with a wide spectrum of new drugs in vogue. However, standard of treatment is yet to be established through randomized clinical trials. This review article discusses the current approach to multimodal treatment options for CSC including conventional as well as newer therapeutic modalities.
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Affiliation(s)
- George Joseph Manayath
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Ratnesh Ranjan
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Smita S. Karandikar
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Vanee Sheth Shah
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Veerappan R. Saravanan
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Venkatapathy Narendran
- Department of Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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15
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Abstract
Fundus autofluorescence (FAF) imaging is based on the fluorescence from ocular endogenous fluorophores located in the retinal pigment epithelium and choroid, mainly lipofuscin and melanin. It is a noninvasive technique that provides information about the spatial distribution of lipofuscin/melanin and retinal pigment epithelium health status. An overview about the fluorophores responsible for FAF imaging and the usefulness of FAF imaging in the noninvasive assessment and monitoring of retinal diseases, such as age-related macular degeneration, diabetic retinopathy, diabetic macular edema, central serous chorioretinopthy, retinitis pigmentosa and retinal dystrophies, are discussed in this review.
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Affiliation(s)
- Ana M Calvo-Maroto
- Department of Ophthalmology, Clínica Universidad de Navarra, University of Navarra, Madrid, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain,
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Ashraf H, Jamshidian M, Khalili MR, Zare M, Shamsi A. Subthreshold Continuous Wave Autofluorescence-controlled Laser Treatment of Chronic Central Serous Chorioretinopathy. J Ophthalmic Vis Res 2018; 13:236-240. [PMID: 30090178 PMCID: PMC6058563 DOI: 10.4103/jovr.jovr_9_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose To investigate the therapeutic effect of clinically invisible subthreshold continuous wave autofluorescence-controlled laser treatment on visual acuity and macular status of patients with chronic central serous chorioretinopathy (CSCR). Methods In this prospective case series, patients with clinical and fluorescein angiographic (FA) findings of CSCR and chronic visual loss (>6 months) were included. Complete ocular examination, FA, and optical coherence tomography (OCT) tests were performed. Each eye was subjected to a direct laser treatment of leakage points by 532 nm continuous wave low energy laser pulses, which were kept invisible by reducing the power to 70% of the threshold test spot. Considering the lack of visible effect on the retinal pigment epithelium (RPE), the laser effect was monitored by pre- and post -treatment infrared and autofluorescence images. Results A total of 20 patients were included in this study, of whom 12 patients (9 male and 3 female patients) with an average age of 38 years had complete follow-up (Average: 3.5 months). The mean preoperative visual acuity was 20/80, which improved to 20/40 at the final visit. The mean preoperative central macular thickness (CMT) was 330 μm and the average final CMT in the last OCT test was 188 μm (P = 0.001). Conclusion Subthreshold continuous wave autofluorescence-controlled laser treatment may be a good treatment for chronic CSCR to avoid the risks of retinal damage by clinically suprathreshold laser therapy.
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Affiliation(s)
- Hossein Ashraf
- Poostchi Eye Research Center, Ophthalmology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansooreh Jamshidian
- Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khalili
- Poostchi Eye Research Center, Ophthalmology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Zare
- Department of Ophthalmology, Jahrom University of Medical Sciences, Shiraz, Iran
| | - Anis Shamsi
- Department of Ophthalmology, Kerman University of Medical Sciences, Kerman, Iran
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Alsmman AH, Mostafa EM, Mounir A. Combined Argon Laser and Low Dose Acetylsalicylic acid in Treatment of Acute Central Serous Chorioretinopathy. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2018; 7:126-132. [PMID: 30386802 PMCID: PMC6205675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study was designed to evaluate the efficacy of low-dose of oral acetylsalicylic acid (aspirin) with focal argon laser for the treatment of acute central serous chorioretinopathy (CSCR). In this prospective case-control study, 40 Patients with acute CSCR were classified randomly to two groups; group A with no treatment as the control group and group B with argon Laser in focal treatment once, followed by aspirin, 100 mg per day orally, with follow up period of 12 months by evaluation of visual acuity, and by Optical Coherence Tomography (OCT), every three months for one year. Patients in the second group treated with argon Laser and aspirin showed more clinically significant improvement in both visual acuity and OCT macular thickness by the end of the follow-up period when compared with the observational group. It was concluded that argon Laser with low-dose oral aspirin results in improvement of visual acuity and OCT macular thickness.
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Affiliation(s)
| | | | - Amr Mounir
- Sohag Faculty of Medicine, Ophthalmology Department, Sohag, Egypt
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18
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Islam QU, Farooq MA, Mehboob MA. Factors affecting the visual outcome in acute central serous chorioretinopathy. Pak J Med Sci 2017; 33:3-7. [PMID: 28367162 PMCID: PMC5368324 DOI: 10.12669/pjms.331.11664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To determine the visual outcome in patients with acute Central serous chorioretinopathy (CSCR) and to analyze the association of clinical, angiographic and tomographic factors with final visual outcome in Pakistani population. Methods: This study was conducted at AFIO Rawalpindi and PNS Shifa Naval hospital Karachi from November 2011 to August 2016. Fifty five eyes of 53 patients with acute CSCR were included. All patients underwent a detailed ophthalmic examination including SD OCT imaging at baseline, One month and three month and FFA was performed at baseline. Primary outcome measures were measurement of initial and final BCVA and CFT. SPSS 13.0 was used for the analysis of data. Results: Mean age of study population was 36.66 ± 6.24 years. On OCT mean CFT at baseline was 467.49 ± 144.80 µm in affected eye, whereas mean CFT measurements at final follow up was 244.67 ± 32.99 µm (p <0.01). Presenting mean log MAR BCVA was 0.47 ± 0.25 and final mean log MAR BCVA was 0.18 ± 0.14 (p <0.01). Baseline BCVA showed statistically significant association with final BCVA (p=0.03). Conclusion: Presenting VA of 6/12 or better is associated with favorable visual outcome in patients with acute CSCR.
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Affiliation(s)
- Qamar Ul Islam
- Dr. Qamar Ul Islam, FCPS (Ophthalmology), FCPS (VRO). Department of Ophthalmology, PNS Shifa Hospital, Karachi
| | | | - Mohammad Asim Mehboob
- Dr. Mohammad Asim Mehboob, MBBS. Department of Ophthalmology, PNS Shifa Hospital, Karachi
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Tekin K, Sekeroglu MA, Cankaya AB, Teke MY, Doguizi S, Yilmazbas P. Intravitreal Bevacizumab and Ranibizumab in the Treatment of Acute Central Serous Chorioretihopathy: A Single Center Retrospective Study. Semin Ophthalmol 2016; 33:265-270. [PMID: 27841949 DOI: 10.1080/08820538.2016.1228985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate and compare the anatomical and functional outcomes of patients with acute central serous chorioretinopathy (CSC) who did not receive any intervention or treatment with intravitreal bevacizumab or ranibizumab. METHODS A single-center retrospective comparative study. Seventy eyes of 70 patients were recruited for the study; 27 patients were only observed without any medication or intervention (observation group), 23 were treated with intravitreal bevacizumab (IVB group), and the remaining 20 were treated with intavitreal ranibizumab (IVR group). The best-corrected visual acuity (BCVA) and central macular thickness (CMT) obtained by spectral-domain optical coherence tomography were compared between the groups. RESULTS There were no significant differences between the groups with regard to age, sex, and follow-up periods (p>0.05). The mean time from baseline to initial complete resolution of subretinal fluid was 3.52±1.64 months in the observation group, 1.19±0.60 months in the IVB group, and 1.11±0.47 months in the IVR group; the resolution time was significantly longer in the observation group (p<0.001). While the CMT was significantly thicker in the observation group when compared to the IVB and IVR groups in the first month (p=0.001), it was similar between the groups in the third, sixth, and twelfth months (p>0.05). Additionally, pairwise comparisons of the IVB and IVR groups revealed that there were no significant differences between these groups regarding CMT at any follow-up time (p>0.05). CONCLUSIONS Compared with observation alone, neither IVB nor IVR had a positive effect in terms of anatomical and functional outcomes for acute CSC. Although the resolution time of SRF is shorter by using ranibizumab, both the ranibizumab and bevacizumab could be effective in achieving rapid resolution of serous detachment in patients with acute CSC.
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Affiliation(s)
- Kemal Tekin
- a Ankara Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | | | | | - Mehmet Yasin Teke
- a Ankara Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Sibel Doguizi
- a Ankara Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Pelin Yilmazbas
- a Ankara Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
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Calvo-Maroto AM, Esteve-Taboada JJ, Domínguez-Vicent A, Pérez-Cambrodí RJ, Cerviño A. Confocal scanning laser ophthalmoscopy versus modified conventional fundus camera for fundus autofluorescence. Expert Rev Med Devices 2016; 13:965-978. [PMID: 27634136 DOI: 10.1080/17434440.2016.1236678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Fundus autofluorescence (FAF) is a noninvasive imaging method to detect fundus endogenous fluorophores, mainly lipofuscin located in the retinal pigment epithelium (RPE). The FAF provides information about lipofuscin distribution and RPE health, and consequently an increased accumulation of lipofuscin has been correlated with ageing and development of certain retinal conditions. Areas covered: An exhaustive literature search in MEDLINE (via OVID) and PUBMED for articles related to ocular FAF in retinal diseases and different devices used for acquiring FAF imaging was conducted. Expert commentary: This review aims to show an overview about autofluorescence in the RPE and the main devices used for acquiring these FAF images. The knowledge of differences in the optical principles, acquisition images and the image post-processing between confocal scanning laser ophthalmoscopy and modified conventional fundus camera will improve the FAF images interpretation when are used as a complementary diagnosis and monitoring tool of retinal diseases.
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Affiliation(s)
- Ana M Calvo-Maroto
- a Optometry Research Group, Department of Optics & Optometry & Vision Sciences , University of Valencia , Valencia , Spain
| | - Jose J Esteve-Taboada
- a Optometry Research Group, Department of Optics & Optometry & Vision Sciences , University of Valencia , Valencia , Spain
| | - Alberto Domínguez-Vicent
- a Optometry Research Group, Department of Optics & Optometry & Vision Sciences , University of Valencia , Valencia , Spain
| | | | - Alejandro Cerviño
- a Optometry Research Group, Department of Optics & Optometry & Vision Sciences , University of Valencia , Valencia , Spain
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21
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Khan MS, Sameen M, Lodhi AA, Ahmed M, Ahmed N, Kamal M, Junejo SA. Effect of half adult dose of oral Rifampicin (300mg) in patients with idiopathic central serous chorioretinopathy. Pak J Med Sci 2016; 32:1158-1163. [PMID: 27882013 PMCID: PMC5103125 DOI: 10.12669/pjms.325.10755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: To evaluate the effect of half adult dose of oral Rifampicin on mean change in best corrected visual acuity and central macular thickness in patients with central serous chorioretinopathy. Methods: Thirty-eight eyes of 31 patients with idiopathic central serous chorioretinopathy (CSCR) were registered. Unaided Visual acuity, best corrected visual acuity was documented and detailed slit lamp examination along with dilated ophthalmoscopy was performed. All subjects were treated with oral Rifampicin 300 mg (half adult dose) daily for 03 months. Patients underwent a complete ocular and systemic examination as well as central macular thickness (CMT) measurement by optical coherence tomography (OCT) every month after starting treatment until four months. Fundus fluorescein angiography (FFA) was performed in recurrent cases. Liver function tests were carried out prior to the treatment and during follow up period. Results: A total of 38 eyes of 31 patients (24 males, 07 females) were included in the study. Mean age of patients was 36.16±3.19 years (range 30-44). Mean best corrected visual acuity (BCVA) before treatment was 0.56±0.11 and improved to 0.47±0.14 at 04 weeks (P<0.001) of treatment. The mean CMT at the time of presentation was 494.39±96.29 um and was decreased to 306.90±50.71 um after 04 weeks of treatment (P<0.001). The mean induced reduction in CMT was 187.48±122 um (P<0.001) while that in BCVA 0.41±0.16 at 04 weeks of treatment (P<0.001). Liver function tests were within normal range before and after the treatment. Conclusion: Half adult dose rifampicin (300mg) is effective and safe in treatment of central serous chorioretinopathy without causing any systemic imbalance.
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Affiliation(s)
- Muhammad Saim Khan
- Muhammad Saim Khan, Department of Ophthalmology, Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi, Pakistan
| | - Murtaza Sameen
- Murtaza Sameen, Department of Ophthalmology, Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi, Pakistan
| | - Arshad Ali Lodhi
- Arshad Ali Lodhi, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
| | - Munawar Ahmed
- Munawar Ahmed, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
| | - Noman Ahmed
- Noman Ahmed, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
| | - Mustafa Kamal
- Mustafa Kamal, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
| | - Sameen Afzal Junejo
- Sameen Afzal Junejo, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
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Ángel-Pereira D, Rocha-Cabrera P, Cordovés-Dorta L, Losada Castillo MJ, Blasco Alberto A, Abreu Reyes JA. Spironolactone, a therapeutic alternative in the treatment of diffuse retinal pigment epitheliopathy. ACTA ACUST UNITED AC 2016; 91:599-603. [PMID: 27017536 DOI: 10.1016/j.oftal.2016.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 11/29/2022]
Abstract
CASE REPORT Two cases are presented of patients with chronic diffuse epitheliopathy (CDE) that showed a favourable response when treated with spironolactone. The first patient had regions of neurosensory detachment (DNS) and the second, multiple DNS, secondary intra-retinal cysts and retinal pigment epithelium detachment. DISCUSSION After treatment with spironolactone, both patients showed a visual acuity improvement and structural changes (reduced neurosensory retinal detachment and cystoid degeneration). Aldosterone receptor agonists (ARA) used for persistent forms of chronic central serous chorioretinopathy show encouraging results and could represent a therapeutic alternative for CDE.
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Affiliation(s)
- D Ángel-Pereira
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España.
| | - P Rocha-Cabrera
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
| | - L Cordovés-Dorta
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
| | - M J Losada Castillo
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
| | - A Blasco Alberto
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
| | - J A Abreu Reyes
- Servicio de Oftalmología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
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