[1]陈莲,何珂,李晓清,等.非那雄胺在慢性中心性浆液性脉络膜视网膜病变患者中的应用[J].眼科新进展,2020,40(5):474-477.[doi:10.13389/j.cnki.rao.2020.0109]
　CHEN Lian,HE Ke,LI Xiaoqing,et al.Clinical effect of Finasteride on chronic central serous chorioretinopathy[J].Recent Advances in Ophthalmology,2020,40(5):474-477.[doi:10.13389/j.cnki.rao.2020.0109]
点击复制

非那雄胺在慢性中心性浆液性脉络膜视网膜病变患者中的应用/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年5期
页码:
474-477
栏目:
应用研究
出版日期:
2020-05-05

文章信息/Info

Title:
Clinical effect of Finasteride on chronic central serous chorioretinopathy
作者:
陈莲; 何珂; 李晓清; 姜钊; 李璐希; 张鹏
710018　陕西省西安市，西安市第三医院眼科，西北大学附属医院眼科
Author(s):
CHEN Lian; HE Ke; LI Xiaoqing; JIANG Zhao; LI Luxi; ZHANG Peng
Department of Ophthalmology,Xi’an No.3 Hospital,the Affiliated Hospital of Northwest University,Xi’an 710018,Shaanxi Province,China
关键词:
非那雄胺; 慢性中心性浆液性脉络膜视网膜病变; 光学相干断层扫描
Keywords:
Finasteride;  chronic central serous chorioretinopathy;  optical coherence tomography
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2020.0109
文献标志码:
A
摘要:
目的　评估非那雄胺治疗慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的有效性及安全性。方法　选取2017年3月至2019年6月在本院确诊的慢性CSC患者31例40眼，采用单臂试验对患者进行非那雄胺治疗。使用非那雄胺治疗后6个月，对患者的视网膜神经上皮层（retinal neuroepithelial layer,RNL）下积液状况，ETDRS视力以及黄斑中心凹视网膜厚度（central foveal thickness,CFT）进行检查。结果　非那雄胺治疗后1个月，有10眼（25.0%）RNL下积液完全消退。持续治疗2个月、3个月、4个月、5个月、6个月，分别有7眼（17.5%）、6眼（15.0%）、7眼（17.5%）、3眼（7.5%）及3眼（7.5%）RNL下积液消退，仅有4眼（10.0%）在治疗后6个月RNL下积液仍存在。患眼EDTRS视力：非那雄胺治疗后1个月为（50.00±16.11）个字母，与治疗前（46.16±16.67）个字母差异无统计学意义（P=0.221 3）；治疗后2个月（53.39±14.67）个字母，较治疗前显著升高（P=0.000 3）；治疗后3个月、4个月、5个月、6个月，分别为（57.39±12.76）个字母、（58.52±12.39）个字母、（59.13±10.76）个字母及（60.42±10.96）个字母，与治疗前相比差异均有统计学意义（均为P<0.000 1）。而患眼CFT自治疗后1个月、2个月、3个月、4个月、5个月、6个月分别为（274.10±22.74）μm、（273.00±17.22）μm、（263.50±12.81）μm、（263.90±10.62）μm、（259.70±12.48）μm及（252.60±11.00）μm，与治疗前（296.60±35.41）μm相比，差异均有统计学意义（均为P<0.05）。所有患者均无服药后身体不适或并发症发生。结论　非那雄胺对于慢性CSC的治疗安全且有效，有望成为慢性CSC的治疗选择。
Abstract:
Objective　To evaluate the efficacy and safety of Finasteride treatment in patients with chronic central serous chorioretinopathy (CSC).Methods　In the context of a prospective single-arm trial, 31 patients (40 eyes) diagnosed with chronic CSC in our hospital from March 2017 to June 2019 received Finasteride treatment. The status of retinal neuroepithelial layer (RNL) fluid, early treatment of diabetic retinopathy study (ETDRS) vision and central foveal thickness (CFT) were examined 6 months after Finasteride treatment. Results　Totally 10 eyes (25.0%) had complete resolution of RNL fluid at the first month after Finasteride treatment. There were 7 eyes (17.5%), 6 eyes (15.0%), 7 eyes (17.5%), 3 eyes (7.5%) and 3 eyes (7.5%) with resolution of RNL fluid at 2, 3, 4, 5 and 6 months after continuous treatment, respectively, and only 4 eyes (10.0%) still had RNL fluid 6 months after treatment. The mean ETDRS vision: (50.00 ± 16.11) letters at the first month of finasteride treatment, which had no significant difference with (46.16±16.67) letters before treatment (P=0.221 3); (53.39±14.67) letters at the second month of treatment, which was significantly higher than that before treatment (P=0.000 3); (57.39±12.76), (58.52±12.39), (59.13±10.76) and (60.42± 10.96) letters at 3, 4, 5 and 6 months after treatment, respectively, which were obviously higher than that before treatment (all P<0.000 1). The CFT of affected eyes were (274.10±22.74) μm, (273.00±17.22) μm, (263.50±12.81) μm, (263.90±10.62) μm, (259.70±12.48) μm and (252.60±11.00) μm at 1, 2, 3, 4, 5 and 6 months after treatment, all of which had significant difference with (296.60±35.41) μm before treatment (all P<0.05). No adverse events occurred in the patients during treatment. Conclusion　Finasteride is a safe and effective treatment for chronic CSC. It may be an alternative way for management of chronic CSC.

参考文献/References:

［1］　MANAYATH G J,RANJAN R,KARANDIKER S S,SHAH V S,SARAVANAN V R,NARENDRAN V.Central serous chorioretinopathy:Current update on management［J］.Oman J Ophthalmol,2018,11(3):200-206.
［2］　TSAI D C,CHEN S J,HUANG C C,CHOU P,CHUNG C M,HUANG P H,et al.Epidemiology of idiopathic central serous chorioretinopathy in Taiwan,2001-2006:A population-based study［J］.PLoS One,2013,8(6):e66858.
［3］　唐娜,王敏,燕振国,岳红云,冯建宇,卢卓锦.血清中睾酮和雌激素水平与中心性浆液性脉络膜视网膜病变的关系［J］.中华眼底病杂志,2010,26(1):55-57.
TANG N,WANG M,YAN Z G,YUE H Y,FENG J Y,LU Z J.The relationship between the level of testosterone and estradiol in serum and central serous chorioretinopathy［J］.Chin J Ocul Fundus Dis,2010,26(1):55-57.
［4］　GRIESHABER M C,STAUB J J,FLAMMER J.The potential role of testosterone in central serous chorioretinopathy［J］.Br J Ophthalmol,2007,91(1):118-119.
［5］　CHATZIRALLI I,KABANAROU S A,PARIKAKIS E,CHATZIRALLIS A,XIROU T,MITROPOULOS P.Risk factors for central serous chorioretinopathy:multivariate approach in a case-control study［J］.Curr Eye Res,2017,42(7):1069-1073.
［6］　PANG C E,SHAH V P,SARRAF D,FREUND K B.Ultra-widefield imaging with autofluorescence and indocyanine green angiography in central serous chorioretinopathy［J］.Am J Ophthalmol,2014,158(2):362-371.
［7］　BUJARBORUA D.Long-term follow-up of idiopathic central serous chorioretinopathy without laser［J］.Acta Ophthalmol Scand,2001,79(4):417-421.
［8］　连海燕,宋艳萍.阈下微脉冲激光光凝对慢性中心性浆液性脉络膜视网膜病变的疗效分析［J］.眼科,2017,26(3):185-190.
LIAN H Y,SONG Y P.Efficacy of subthreshold micropulse yellow laser (577 nm) photocoagulation for chronic central serous chorioretinopathy［J］.Ophthalmol CHN,2017,26(3):185-190.
［9］　BREUKINK M B,MOHR J K,OSSEWAARDE-VAN NOREL A,DEN HOLLANDER A I,KEUNEN J E,HOYING C B,et al.Half-dose photodynamic therapy followed by diode micropulse laser therapy as treatment for chronic central serous chorioretinopathy:evaluation of a prospective treatment protocol［J］.Acta Ophthalmol,2016,94(2):187-197.
［10］　LAI F H,NG D S,BAKTHAVATSALAM M,CHAN V C,YOUNG A L,LUK F O,et al.A multicenter study on the long-term outcomes of half-dose photodynamic therapy in chronic central serous chorioretinopathy［J］.Am J Ophthalmol,2016,170:91-99.
［11］　YANG D,ELIOTT D.Systemic mineralocorticoid antagonists in the treatment of central serous chorioretinopathy［J］.Semin Ophthalmol,2017,32(1):36-42.
［12］　MOISSEIEV E,HOLMES A J,MOSHIRI A,MORSE L S.Finasteride is effective for the treatment of central serous chorioretinopathy［J］.Eye (Lond),2016,30(6):850-856.

相似文献/References:

[1]李娟娟 李燕.慢性中心性浆液性脉络膜视网膜病变视网膜色素上皮细胞萎缩轨迹的临床观察[J].眼科新进展,2013,33(8):000.
[2]吴敏,胡竹林,薛黎萍,等. 半剂量维替泊芬和半能量PDT治疗慢性中心性浆液性脉络膜视网膜病变[J].眼科新进展,2015,35(7):646.[doi:10.13389/j.cnki.rao.2015.0176]
　WU Min,HU Zhu-Lin,XUE Li-Ping,et al. Half-dose verteporfin and half laser power PDT for chronic central serous chorioretinopathy[J].Recent Advances in Ophthalmology,2015,35(5):646.[doi:10.13389/j.cnki.rao.2015.0176]
[3]马为梅,雷晓琴,田芳,等.半剂量维替泊芬与半能量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].眼科新进展,2017,37(4):341.[doi:10.13389/j.cnki.rao.2017.0086]
　MA Wei-Mei,LEI Xiao-Qin,TIAN Fang,et al.Half-dose verteporfin and half-fluence photodynamic therapy for chronic central serous chorioretinopathy[J].Recent Advances in Ophthalmology,2017,37(5):341.[doi:10.13389/j.cnki.rao.2017.0086]
[4]廖丹,许立帅,戴乐,等.577 nm阈下微脉冲激光治疗黄斑中心凹渗漏的慢性中心性浆液性脉络膜视网膜病变[J].眼科新进展,2018,38(2):139.[doi:10.13389/j.cnki.rao.2018.0030]
　LIAO Dan,XU Li-Shuai,DAI Le,et al.Subthreshold micropulse yellow laser (577 nm) for chronic central serous chorioretinopathy with foveal leakage[J].Recent Advances in Ophthalmology,2018,38(5):139.[doi:10.13389/j.cnki.rao.2018.0030]
[5]肖艳辉,刘高勤,夏蔚.慢性中心性浆液性脉络膜视网膜病变与息肉样脉络膜血管病变多模式影像学特征的比较[J].眼科新进展,2020,40(12):1139.[doi:10.13389/j.cnki.rao.2020.0253]
　XIAO Yanhui,LIU Gaoqin,XIA Wei.Multimodal imaging comparison of chronic central serous chorioretinopathy and polypoidal choroidal vasculopathy[J].Recent Advances in Ophthalmology,2020,40(5):1139.[doi:10.13389/j.cnki.rao.2020.0253]

备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2020-05-05