PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to investigate optical coherence tomography (OCT) biomarkers as potential predictors of treatment response in chronic central serous chorioretinopathy (CSCR).
METHODS: It was a retrospective cohort study that included 42 patients with chronic CSCR. After complete ocular and hematological examinations, all patients received 50 mg/day of oral eplerenone for three months and were followed for at least six months. All participants were divided into two groups: Group 1 participants with a positive response to treatment (complete resolution of subretinal fluid (SRF) at six months) and Group 2 poor responders (moderate or less than 50% reduction in SRF from baseline). The primary outcome measure was the resolution of SRF, and various OCT biomarkers like central macular thickness (CMT), pigment epithelial detachments (PED), double-layer sign, elongation of the photoreceptor\'s outer segment, the integrity of the external limiting membrane, the integrity of the ellipsoid zone, hyperreflective foci in the outer segment, and subretinal deposits in the SRF were assessed.
RESULTS: The mean age was 41.33 ± 10.75 years, and 34 participants were male. Thirty-seven (88.1%) of the participants had good responses to eplerenone, with the mean height of SRF decreasing significantly from a maximum of 269.74 µm to a minimum of 21.86 µm at six months (p<0.001). The mean CMT decreased from the first visit time point to the third visit time (p<0.001). Logistic regression analysis assessed the absence of PED and double-layer signs associated with a good response.
CONCLUSIONS: The eplerenone therapy seems to be efficient for chronic CSCR, and OCT can be an invaluable aid to the treating physician.
METHODS: It was a retrospective cohort study that included 42 patients with chronic CSCR. After complete ocular and hematological examinations, all patients received 50 mg/day of oral eplerenone for three months and were followed for at least six months. All participants were divided into two groups: Group 1 participants with a positive response to treatment (complete resolution of subretinal fluid (SRF) at six months) and Group 2 poor responders (moderate or less than 50% reduction in SRF from baseline). The primary outcome measure was the resolution of SRF, and various OCT biomarkers like central macular thickness (CMT), pigment epithelial detachments (PED), double-layer sign, elongation of the photoreceptor\'s outer segment, the integrity of the external limiting membrane, the integrity of the ellipsoid zone, hyperreflective foci in the outer segment, and subretinal deposits in the SRF were assessed.
RESULTS: The mean age was 41.33 ± 10.75 years, and 34 participants were male. Thirty-seven (88.1%) of the participants had good responses to eplerenone, with the mean height of SRF decreasing significantly from a maximum of 269.74 µm to a minimum of 21.86 µm at six months (p<0.001). The mean CMT decreased from the first visit time point to the third visit time (p<0.001). Logistic regression analysis assessed the absence of PED and double-layer signs associated with a good response.
CONCLUSIONS: The eplerenone therapy seems to be efficient for chronic CSCR, and OCT can be an invaluable aid to the treating physician.
摘要：
目的：本研究旨在探讨光学相干断层扫描（OCT）生物标志物作为慢性中心性浆液性脉络膜视网膜病变（CSCR）治疗反应的潜在预测因子。
方法：这是一项回顾性队列研究，包括42例慢性CSCR患者。完成眼部和血液学检查后，所有患者均接受50mg/d口服依普利酮治疗3个月,随访至少6个月.所有参与者分为两组：第1组参与者对治疗反应积极（6个月时视网膜下液（SRF）完全缓解）和第2组反应不佳（SRF从基线降低中度或低于50％）。主要结果指标是SRF的分辨率，和各种OCT生物标志物，如中央黄斑厚度（CMT），色素上皮脱离（PED），双层标志,感光体外段的伸长，外部限制膜的完整性，椭球区的完整性，外段的超反射焦点，评估SRF中的视网膜下沉积。
结果：平均年龄为41.33±10.75岁，34名参与者为男性。37名(88.1%)的参与者对依普利酮有良好的反应，在六个月时，SRF的平均高度从最大269.74µm显着降低到最小21.86µm（p<0.001）。平均CMT从第一次就诊时间点到第三次就诊时间降低(p<0.001)。Logistic回归分析评估了PED的缺失和与良好反应相关的双层体征。
结论：依普利酮治疗慢性CSCR似乎有效，和OCT可以是一个宝贵的援助治疗医生。
方法：这是一项回顾性队列研究，包括42例慢性CSCR患者。完成眼部和血液学检查后，所有患者均接受50mg/d口服依普利酮治疗3个月,随访至少6个月.所有参与者分为两组：第1组参与者对治疗反应积极（6个月时视网膜下液（SRF）完全缓解）和第2组反应不佳（SRF从基线降低中度或低于50％）。主要结果指标是SRF的分辨率，和各种OCT生物标志物，如中央黄斑厚度（CMT），色素上皮脱离（PED），双层标志,感光体外段的伸长，外部限制膜的完整性，椭球区的完整性，外段的超反射焦点，评估SRF中的视网膜下沉积。
结果：平均年龄为41.33±10.75岁，34名参与者为男性。37名(88.1%)的参与者对依普利酮有良好的反应，在六个月时，SRF的平均高度从最大269.74µm显着降低到最小21.86µm（p<0.001）。平均CMT从第一次就诊时间点到第三次就诊时间降低(p<0.001)。Logistic回归分析评估了PED的缺失和与良好反应相关的双层体征。
结论：依普利酮治疗慢性CSCR似乎有效，和OCT可以是一个宝贵的援助治疗医生。
