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Der Ophthalmologe

, Volume 116, Issue 2, pp 189–200 | Cite as

Behandlung der Chorioretinopathia centralis serosa mittels Aldosteronantagonisten

  • B. Cakir
  • H. Agostini
  • C. LangeEmail author
Das therapeutische und diagnostische Prinzip
  • 146 Downloads

Zusammenfassung

Hintergrund

Seit dem letzten Beitrag zum therapeutischen Prinzip „Mineralokortikoidrezeptoraantagonisten als Therapieoption bei akuter und chronischer Chorioretinopathia centralis serosa“ (CCS) von Maier et al. sind mehr als 3 Jahre vergangen, und eine Vielzahl neuer Studien wurden über dieses Thema publiziert. Ziel dieser Arbeit ist es daher, die aktuelle Studienlage und den Stellenwert von Aldosteronaantagonisten in der Behandlung der CCS erneut zu evaluieren.

Methoden und Ergebnisse

Nach ausführlicher Literaturrecherche über PubMed wurden insgesamt 20 relevante Studien, die von 2013 bis 2017 veröffentlicht wurden, in Hinblick auf die Wirkung von Aldosteronantagonisten in der Behandlung der CCS ausgewertet. Aufgrund der Variabilität der Studienprotokolle, der unterschiedlichen primären Endpunkte und Nachbeobachtungszeiträume lassen sich die Studien jedoch nur unzureichend vergleichen. Zudem sind alle Studien aufgrund geringer Fallzahlen bei einem per se heterogenen Krankheitsbild in ihrer Aussagekraft limitiert. Dennoch weist die aktuelle Studienlage darauf hin, dass Aldosteronantagonisten die Reabsorption der subretinalen Flüssigkeit begünstigen und den Visusverlauf bei Patienten mit CCS positiv beeinflussen können. Eplerenon kann aufgrund seines geringeren Nebenwirkungsprofils bei CCS-Patienten mit sich nichtreabsorbierender subretinaler Flüssigkeit eine Therapieoption darstellen.

Schlussfolgerung

Weitere prospektive randomisierte Studien mit einheitlichen Definitionen und Einteilung der Krankheitsstadien sowie gemeinsame Studienkriterien sind notwendig, um den postulierten Therapieeffekt zu validieren und den optimalen Zeitpunkt des Beginns und die notwendige Dauer der Therapie festzulegen.

Schlüsselwörter

Chorioretinopathia centralis serosa Choroidea Choroideaerkrankungen Sehstörungen Mineralokortikoidrezeptorantagonisten 

Treatment of central serous chorioretinopathy with mineralocorticoid receptor antagonists

Abstract

Background

Over 3 years have passed since the last publication on the therapeutic principle “Mineralocorticoid receptor antagonists as treatment option for acute and chronic central serous chorioretinopathy” by Maier et al., and numerous new studies have been published on the topic. The aim of this work is to provide an update on the current literature and reevaluate the role of mineralocorticoid receptor antagonists in the treatment of central serous chorioretinopathy (CSC).

Methods and results

A computer-based literature search in PubMed yielded a total of 20 relevant articles published from 2013 to 2017, which were evaluated in terms of the effect of mineralocorticoid receptor antagonists in CSC treatment. Due to study protocol variability with different primary endpoints and follow-up periods, an in-depth comparison of the selected studies could not be performed. Moreover, the small study populations further limit their validity in this per se heterogeneous disease spectrum. Despite these limitations, current data indicate that aldosterone antagonists are effective in decreasing subretinal fluid and improving visual acuity in patients with CSC. The selective aldosterone antagonist eplerenone with a low side effect profile is a treatment option in patients with non-resolving CSC.

Conclusion

Prospective, randomized studies with uniform disease definition and study criteria are necessary to validate the therapeutic effect and to determine the ideal time of intervention and treatment duration.

Keywords

Central serous chorioretinopathy Choroid Choroid diseases Vision disorders Mineralocorticoid receptor antagonists 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

B. Cakir, H. Agostini und C. Lange geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Augenheilkunde, Medizinische FakultätUniversitätsklinikum FreiburgFreiburgDeutschland

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