M Maier1, S Stumpfe, N Feucht, P Strobl, V Rath, C P Lohmann. 1. Augenklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland, Mathias.Maier@mri.tum.de.
Abstract
BACKGROUND: It is well known that central serous chorioretinopathy (CSCR) is triggered by endogenous and exogenous glucocorticoids but the exact pathomechanism is not completely understood. According to the results of previous studies overactivation of mineralocorticoid receptors may play a decisive role in the pathogenesis of CSCR. METHODS AND RESULTS: Experimental studies have shown that overactivation of mineralocorticoid receptors in endothelial cells of the choroid induces increased permeability. In a pilot study inhibition of mineralocorticoid receptors was successful in treating CSCR. This article reports about the use of spironolactone in the treatment of CSCR. In this observational case series spectral-domain optical coherence tomographv (SD-OCT) showed either reduction or complete reabsorption of subretinal fluid. In pilot studies and in this case series inhibition of mineralocorticoid receptors as a therapeutic option was effective and safe; however, the efficacy is difficult to distinguish from spontaneous recovery, especially in acute CSCR. CONCLUSION: For further assessment of this treatment controlled clinical trials are urgently required as this therapy would offer a new approach for patients with chronic CSCR and no tendency towards recovery.
BACKGROUND: It is well known that central serous chorioretinopathy (CSCR) is triggered by endogenous and exogenous glucocorticoids but the exact pathomechanism is not completely understood. According to the results of previous studies overactivation of mineralocorticoid receptors may play a decisive role in the pathogenesis of CSCR. METHODS AND RESULTS: Experimental studies have shown that overactivation of mineralocorticoid receptors in endothelial cells of the choroid induces increased permeability. In a pilot study inhibition of mineralocorticoid receptors was successful in treating CSCR. This article reports about the use of spironolactone in the treatment of CSCR. In this observational case series spectral-domain optical coherence tomographv (SD-OCT) showed either reduction or complete reabsorption of subretinal fluid. In pilot studies and in this case series inhibition of mineralocorticoid receptors as a therapeutic option was effective and safe; however, the efficacy is difficult to distinguish from spontaneous recovery, especially in acute CSCR. CONCLUSION: For further assessment of this treatment controlled clinical trials are urgently required as this therapy would offer a new approach for patients with chronic CSCR and no tendency towards recovery.
Authors: H Elsner; E Pörksen; C Klatt; A Bunse; D Theisen-Kunde; R Brinkmann; R Birngruber; H Laqua; J Roider Journal: Graefes Arch Clin Exp Ophthalmol Date: 2006-12 Impact factor: 3.117
Authors: R F Spaide; L Campeas; A Haas; L A Yannuzzi; Y L Fisher; D R Guyer; J S Slakter; J A Sorenson; D A Orlock Journal: Ophthalmology Date: 1996-12 Impact factor: 12.079
Authors: Karen B Schaal; Alexandra E Hoeh; Alexander Scheuerle; Florian Schuett; Stefan Dithmar Journal: Eur J Ophthalmol Date: 2009 Jul-Aug Impact factor: 2.597
Authors: Tina Rike Herold; Kristina Rist; Siegfried Georg Priglinger; Michael Werner Ulbig; Armin Wolf Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-07-31 Impact factor: 3.117