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

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=0.2213);治疗后2个月(53.39±14.67)个字母,较治疗前显著升高(P=0.0003);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<0.0001)。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。

Clinical effect of Finasteride on chronic central serous chorioretinopathy

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.