Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy

Abstract To compare the macular morphology of good and poor responders to eplerenone treatment in chronic central serous chorioretinopathy (CSCR) patients. Thirty eyes of 29 patients with chronic CSCR were treated with 50 mg/day oral eplerenone and followed up for 1 year. The integrity of outer reti...

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Autores principales:	Róbert Gergely, Illés Kovács, Zsuzsanna Récsán, Gábor László Sándor, Cecília Czakó, Zoltán Zsolt Nagy, Mónika Ecsedy
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/71e240a0775f40aeace8b5eec42d1318
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spelling	oai:doaj.org-article:71e240a0775f40aeace8b5eec42d13182021-12-02T18:37:06ZPredictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy10.1038/s41598-020-73959-42045-2322https://doaj.org/article/71e240a0775f40aeace8b5eec42d13182020-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-73959-4https://doaj.org/toc/2045-2322Abstract To compare the macular morphology of good and poor responders to eplerenone treatment in chronic central serous chorioretinopathy (CSCR) patients. Thirty eyes of 29 patients with chronic CSCR were treated with 50 mg/day oral eplerenone and followed up for 1 year. The integrity of outer retinal layers at baseline was assessed using optical coherence tomography. Patients who showed complete resolution of subretinal fluid at 1 year were assigned to the good responder group (Group 1), whilst those who showed moderate or no resolution were classified as poor responders (Group 2). Ellipsoid zone interruption, ELM interruption and hyperreflective foci in outer segment (OS) and outer nuclear layer (ON layer) was significantly more frequent in Group 2 than in Group 1 (p < 0.05 for all parameteres). Outer segment elongation was significantly more frequently seen in Group 1 than in Group 2 (p < 0.05) Multivariable regression analysis showed that intact ellipsoid zone at baseline is an independent predictor of good therapeutic response, with an odds ratio of 26.00 (95% CI 3.69–183.45; p = 0.001) after controlling for the effect of hyperreflective foci and ELM integrity. There is higher chance of the resolution of subretinal fluid after eplerenone treatment in CSCR patients with intact outer retinal layers at baseline. Baseline morphologic evaluation of the outer retinal layers on OCT scans can be useful in predicting the response to mineralocorticoid antagonist therapy in these patients.Róbert GergelyIllés KovácsZsuzsanna RécsánGábor László SándorCecília CzakóZoltán Zsolt NagyMónika EcsedyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Róbert Gergely Illés Kovács Zsuzsanna Récsán Gábor László Sándor Cecília Czakó Zoltán Zsolt Nagy Mónika Ecsedy Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
description	Abstract To compare the macular morphology of good and poor responders to eplerenone treatment in chronic central serous chorioretinopathy (CSCR) patients. Thirty eyes of 29 patients with chronic CSCR were treated with 50 mg/day oral eplerenone and followed up for 1 year. The integrity of outer retinal layers at baseline was assessed using optical coherence tomography. Patients who showed complete resolution of subretinal fluid at 1 year were assigned to the good responder group (Group 1), whilst those who showed moderate or no resolution were classified as poor responders (Group 2). Ellipsoid zone interruption, ELM interruption and hyperreflective foci in outer segment (OS) and outer nuclear layer (ON layer) was significantly more frequent in Group 2 than in Group 1 (p < 0.05 for all parameteres). Outer segment elongation was significantly more frequently seen in Group 1 than in Group 2 (p < 0.05) Multivariable regression analysis showed that intact ellipsoid zone at baseline is an independent predictor of good therapeutic response, with an odds ratio of 26.00 (95% CI 3.69–183.45; p = 0.001) after controlling for the effect of hyperreflective foci and ELM integrity. There is higher chance of the resolution of subretinal fluid after eplerenone treatment in CSCR patients with intact outer retinal layers at baseline. Baseline morphologic evaluation of the outer retinal layers on OCT scans can be useful in predicting the response to mineralocorticoid antagonist therapy in these patients.
format	article
author	Róbert Gergely Illés Kovács Zsuzsanna Récsán Gábor László Sándor Cecília Czakó Zoltán Zsolt Nagy Mónika Ecsedy
author_facet	Róbert Gergely Illés Kovács Zsuzsanna Récsán Gábor László Sándor Cecília Czakó Zoltán Zsolt Nagy Mónika Ecsedy
author_sort	Róbert Gergely
title	Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
title_short	Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
title_full	Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
title_fullStr	Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
title_full_unstemmed	Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
title_sort	predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/71e240a0775f40aeace8b5eec42d1318
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Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy

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