Dataset Information

Eplerenone as a novel treatment for persistent subretinal fluid following retinal detachment surgery.

ABSTRACT:

Purpose

To describe the clinical course of a patient with persistent subretinal fluid (SRF) after primary scleral buckle surgery for a rhegmatogenous retinal detachment (RRD) repair who was subsequently treated with oral eplerenone for resolution of SRF.

Observations

A 34 year-old-male presented with a large bullous macula-involving RRD of unknown duration and underwent primary scleral buckle and retinotomy for drainage of subretinal fluid (SRF). His post-operative course was characterized by persistent macular SRF for 1.5 years with poor vision largely unchanged from his pre-operative presentation. Patient declined additional surgical treatment and opted for conservative management. Given such persistent SRF, the patient was trialed on a course of oral eplerenone 50 mg po bid. After only one month on this therapy, a marked decline in SRF was noted with near complete resolution after two months.

Conclusions and importance

To our knowledge, this is the first report of its kind to show the effectivity of oral eplerenone treatment in the reduction of SRF following retinal detachment surgery.

SUBMITTER: Haghighi A

PROVIDER: S-EPMC5956724 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Eplerenone as a novel treatment for persistent subretinal fluid following retinal detachment surgery.

Haghighi Arezu A Do Jiun J Ameri Hossein H

American journal of ophthalmology case reports 20180309

<h4>Purpose</h4>To describe the clinical course of a patient with persistent subretinal fluid (SRF) after primary scleral buckle surgery for a rhegmatogenous retinal detachment (RRD) repair who was subsequently treated with oral eplerenone for resolution of SRF.<h4>Observations</h4>A 34 year-old-male presented with a large bullous macula-involving RRD of unknown duration and underwent primary scleral buckle and retinotomy for drainage of subretinal fluid (SRF). His post-operative course was char ...[more]

PMID: 29780947

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Project description:BackgroundRhegmatogenous retinal detachment (RRD) is a major cause of visual loss in developed countries. Proliferative vitreoretinopathy (PVR), an eye-sight threatening complication of RRD surgery, resembles a wound-healing process with inflammation, scar tissue formation, and membrane contraction. This study was performed to determine the possible involvement of a wide range of cytokines in the future development of PVR, and to identify predictors of PVR and visual outcome.MethodologyA multiplex immunoassay was used for the simultaneous detection of 29 different cytokines in subretinal fluid samples from patients with primary RRD. Of 306 samples that were collected and stored in our BioBank between 2001 and 2008, 21 samples from patients who developed postoperative PVR were compared with 54 age-, sex-, and storage-time-matched RRD control patients who had an uncomplicated postoperative course during the overall follow-up period.FindingsLevels of IL-1?, IL-2, IL-3, IL-6, VEGF, and ICAM-1 were significantly higher (P<0.05) in patients who developed postoperative PVR after reattachment surgery than in patients with an uncomplicated postoperative course, whereas levels of IL-1?, IL-4, IL-5, IL-7, IL-9, IL-10, IL-11, IL-12p70, IL-13, IL-15, IL-17, IL-18, IL-21, IL-22, IL-23, IL-25, IL-33, TNF-?, IFN-?, IGF-1, bFGF, HGF, and NGF were not (P>0.05). Multivariate logistic regression analysis revealed that IL-3 (P?=?0.001), IL-6 (P?=?0.047), ICAM-1 (P?=?0.010), and preoperative visual acuity (P?=?0.026) were independent predictors of postoperative PVR. Linear regression analysis showed that ICAM-1 (P?=?0.005) and preoperative logMAR visual acuity (P?=?0.001) were predictive of final visual outcome after primary RRD repair.Conclusions/significanceOur findings indicate that after RRD onset an exaggerated response of certain cytokines may predispose to PVR. Sampling at a time close to the onset of primary RRD may thus provide clues as to which biological events may initiate the development of PVR and, most importantly, may provide a means for therapeutic control.

Dataset Information

Eplerenone as a novel treatment for persistent subretinal fluid following retinal detachment surgery.

Purpose

Observations

Conclusions and importance

Publications

Eplerenone as a novel treatment for persistent subretinal fluid following retinal detachment surgery.

Similar Datasets

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