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Oral Rifampin treatment for longstanding chronic central serous chorioretinopathy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate the effect of oral Rifampin in patients with chronic central serous chorioretinoapthy (CSCR).

Methods

This was a prospective pilot study of patients with chronic CSCR with persistent subretinal fluid (SRF) for at least 3 months, who were treated with oral Rifampin 300 mg twice per day for 3 months and had 6 months of follow-up. All patients underwent a complete ocular examination and a spectral domain optical coherence tomography (SD-OCT) scan monthly from baseline until month 4, and then at month 6. Fluorescein angiography (FA) was performed at baseline and at the end of the study.

Results

Fourteen eyes of 12 patients were included in the study, nine men and three women. Mean age was 58.5 years (range 32–80). Mean duration of SRF prior to study entry was 28.4 months. Forty-two percent of eyes were treated previously for CSR with thermal laser, PDT, or intravitreal bevacizumab. Mean best corrected visual acuity (BCVA) at presentation was 20/60 and improved to a mean of 20/50 at month 3 (P > 0.05). Retinal thickness was reduced by 25.3 %, 21.2 %, and 21 % on months 1, 2, 3, respectively (P < 0.05). Mean choroidal thickness at presentation was 476 μ (SD 188 μ) decreasing to 427 μ (SD 125 μ) after 3 months of treatment (P > 0.05). SRF was reduced in nine eyes (64 %) and completely resolved in six eyes (42.8 %) at month 3 following 3 months of treatment, and four out of these six eyes remained fluid free at month 6. Two patients stopped the treatment after 2 months due to adverse events.

Conclusions

Oral Rifampin may be a therapeutic option in patients with longstanding chronic CSCR.

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References

  1. Gass JD (1967) Pathogenesis of disciform detachment of neuroepithelium: II. Idiopathic central serous choroidopathy. Am J Ophthalmol 63:587–615

    Google Scholar 

  2. Levine R, Brucker AJ, Robinson F (1989) Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography. Ophthalmology 96:854–859

    Article  PubMed  CAS  Google Scholar 

  3. Loo RH, Scott IU, Flynn HW Jr et al (2002) Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy. Retina 22:19–24

    Article  PubMed  Google Scholar 

  4. Imamura Y, Fujiwara T, Margolis R, Spaide RF (2009) Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina 29:1469–1473

    Article  PubMed  Google Scholar 

  5. Jampol LM, Weinreb R, Yanuzzi LA (2002) Involvement of corticosteroids and catecholmines in the pathogenesis of central serous chorioretinopathy : a rational for new treatment strategies. Ophthalmology 109:1765–1766

    Article  PubMed  Google Scholar 

  6. Nicholson B, Noble J, Forooghian F, Meyerle C (2013) Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 58:103–26

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bousquet E, Beydoun T, Zhao M et al (2013) Mineralocorticoid receptor antagonism in the treatment of chronic central serouschorioretinopathy: a pilot study. Retina 33:2096–102

    Article  PubMed  CAS  Google Scholar 

  8. Silva RM, Ruiz-Moreno JM, Gomez-Ulla F et al (2013) Photodynamic therapy for chronic central serous chorioretinopathy: a 4-year Follow-up study. Retina 33:309–315

    Article  PubMed  CAS  Google Scholar 

  9. Reibaldi M, Cardascia N, Longo A et al (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149:307–315

    Article  PubMed  Google Scholar 

  10. Ruiz-Moreno JM, Lugo FL, Armadá F et al (2010) Photodynamic therapy for chronic central serous chorioretinopathy. Acta Ophthalmol 88:371–376

    Article  PubMed  Google Scholar 

  11. Lim SH, Chang W, Sagong M (2013) Efficacy of half fluence photodynamic therapy depending on the degree of choroidal hyperpermeability in chronic central serous chorioretinopathy. Eye (Lond) 27:353–362

    Article  CAS  Google Scholar 

  12. Smretschnig E, Ansari-Shahrezaei S, Hagen S et al (2013) Half-fluence photodynamic therapy in chronic central serous chrioretinopathy. Retina 33:316–323

    Article  PubMed  CAS  Google Scholar 

  13. Inoue R, Sawa M, Tsujikawa M, Gomi F (2010) Association between the efficacy of photodynamic therapy and Indocyenine green angiography finding for central serous chorioretinopathy. Am J Ophthalmol 149:441–446

    Article  PubMed  CAS  Google Scholar 

  14. Bae SH, Heo J, Kim C et al (2014) Low-fluence photodynamic therapy versus Ranibizumab for chronic Central serous Chorioretinopathy: One-year results of a randomized trial. Ophthalmology 121:558–65

    Article  PubMed  Google Scholar 

  15. Meyerle C, Bailey Freund K et al (2007) Ketoconazole in the treatment of chronic idiopathic central serous chorioretinopathy. Retina 27:943–946

    Article  PubMed  Google Scholar 

  16. Nielsen JS, Weinreb RN, Yannuzzi L, Jampol LM (2007) Mifepristone treatment of chronic central serous chorioretinopathy. Retina 27:119–22

    Article  PubMed  Google Scholar 

  17. Nielsen JS, Jampol LM (2011) Oral mifepristone for chronic central serous chorioretinopathy. Retina 31:1928–36

    Article  PubMed  CAS  Google Scholar 

  18. Kurup SK, Oliver A, Emanuelli A et al (2012) Low-dose methotrexate for the treatment of chronic central serous chorioretinopathy: a retrospective analysis. Retina 32:2096–101

    Article  PubMed  CAS  Google Scholar 

  19. Masayoshi S, Nozomi F, Yutaka K (2009) Rifampicin as an Oral Angiogenesis Inhibitor Targeting Hepatic Cancers. Cancer Res 69:4760–8

    Article  CAS  Google Scholar 

  20. Guengerich FP (1999) Cytochrome P-450 3A4: regulation and role in drug metabolism. Annu Rev Pharmacol Toxicol 39:1–17

    Article  PubMed  CAS  Google Scholar 

  21. Steinle NC, Gupta N, Yuan A, Singh RP (2012) Oral rifampin utilisation for the treatment of chronic multifocal central serous retinopathy. Br J Ophthalmol 96:10–3

    Article  PubMed  Google Scholar 

  22. Spaide RF, Koizumi H, Pozonni MC (2008) Enhanced depth imaging spectral domain optical coherence tomography. Am J Ophthalmol 146:496–500

    Article  PubMed  Google Scholar 

  23. Margolis R, Spaide RF (2009) A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 147:811–815

    Article  PubMed  Google Scholar 

  24. Mårde Arrhén Y, Nylén H, Lövgren-Sandblom A et al (2013) A comparison of 4β-hydroxycholesterol : cholesterol and 6β- hydroxycortisol: cortisol as markers of CYP3A4 induction. Br J Clin Pharmacol 75:1536–40

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Keven K, Uysal AR, Erdogan G (1998) Adrenal function during tuberculous infection and effects of antituberculosis treatment on endogenous andexogenous steroids. Int J Tuberc Lung Dis 2:419–24

    PubMed  CAS  Google Scholar 

  26. Wang M, Munch IC, Hasler PW et al (2008) Central serous chorioretinopathy. Acta Ophthalmol 86:126–45

    Article  PubMed  Google Scholar 

  27. Chikaraishi Y, Matsunaga N, Shimazawa M, Hara H (2008) Rifampicin inhibits the retinal neovascularization in vitro and in vivo. Exp Eye Res 86:131–137

    Article  PubMed  CAS  Google Scholar 

  28. http://www.pdr.net/drug-summary/rifadin?druglabelid=1036&id=2531 (Accessed 10 Jan 2015).

  29. Pikuleva IA (2006) Cytochrome P450s and cholesterol omeostasis. Pharmacol Ther 112:761–73

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Tel-Aviv Medical Center, 6 Weizman Street, Tel Aviv, 64239, Israel

    Shiri Shulman, Dafna Goldenberg, Roy Schwartz, Zohar Habot-Wilner, Adiel Barak, Nurit Ehrlich, Anat Loewenstein & Michaella Goldstein

  2. Sackler faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Shiri Shulman, Dafna Goldenberg, Roy Schwartz, Zohar Habot-Wilner, Adiel Barak, Nurit Ehrlich, Anat Loewenstein & Michaella Goldstein

Authors
  1. Shiri Shulman
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  2. Dafna Goldenberg
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  3. Roy Schwartz
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  4. Zohar Habot-Wilner
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  5. Adiel Barak
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  6. Nurit Ehrlich
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  7. Anat Loewenstein
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  8. Michaella Goldstein
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Corresponding author

Correspondence to Shiri Shulman.

Additional information

This paper was presented in part in the American Academy of Ophthalmology meeting, New Orleans, LA, USA, November 2013.

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Shulman, S., Goldenberg, D., Schwartz, R. et al. Oral Rifampin treatment for longstanding chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 254, 15–22 (2016). https://doi.org/10.1007/s00417-015-2989-z

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  • DOI: https://doi.org/10.1007/s00417-015-2989-z

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