Rifampin Induced Hepatotoxicity During Treatment for Chronic Central Serous Chorioretinopathy

Nelson, James W.; Saggau, David D.; Nielsen, Jared S.

doi:10.1097/icb.0000000000000007

Cited by 15 publications

(10 citation statements)

References 18 publications

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“…In the follow-up period of six months none of the patients had recurrence of the disease and no adverse reactions of the drug were seen in Group-A. Rifampicin in higher doses causes hepatotoxicity as shown by Nelson et al in their case report and Ramappa et al20,21 However, we did not come across any case of hepatotoxicity in our prescribed dose of 600mg for one month during the entire six months’ period. Mildly raised LFTs were seen in Group-B after one-month therapy in four patients, but it was not statistically significant.…”

Section: Discussionmentioning

confidence: 45%

Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

Loya¹,

Ghoghari²,

Rizvi³

et al. 2019

Pak J Med Sci

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Objective: To study the effect of reducing the duration of rifampicin therapy in the treatment of Chronic Central Serous Chorioretinopathy. Methods: This is interventional study conducted in Layton Rahmatullah Benevolent Trust, Free Base Eye Hospital Korangi, Karachi from February 2017 - December 2018. This randomized controlled comparative study included two groups, Groups-A comprised of 48 eyes of 40 cases with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 600mg for one month, and Group-B consisted of 43 eyes of 40 controls with Chronic Central Serous Chorioretinopathy who were given reduced dose of oral rifampicin i.e. 300mg once daily for three months as previously stated in literature. To access the effect of therapy in both the groups, pre-treatment visual acuity on the logMAR and Optical Coherent Tomography (OCT, Heidelberg spectralis) for CMT were performed and repeated on the 1st and 3rd month post-treatment. Patients were also followed for 6 months to access any recurrence. Results: On comparing the two groups, Group-A had improvement in VA and CMT after one month therapy of Rifampicin, Pre-treatment mean VA in Group-A was 0.85 ± 0.19 as compared to the pre-treatment mean VA in Group-B i.e. 0.74+/- 0.208, while the pre-treatment mean CMT was 609.0 ± 178.29 µm in Group-A, and 600.0 +/- 155.09 µm in Group-B respectively. After 1 month of therapy, the visual status, and CMT in Group-A was 0.29+/- 0.21 and 311.6 +/- 89.9, while Group-B, VA was 0.598 +/- 0.23 (p value 0.001%) and CMT was 512.30 +/- 148.37 (p-value 0.001%). Rifampicin was continued in Group-B till three months, and patients were re-accessed but there was no difference in VA and CMT statically. During the 3rd and 6th months of follow up no relapses were reported. Conclusion: This comparative study showed that the group receiving oral rifampicin 600mg for one month showed better outcome at one month and third month than the group receiving oral rifampicin at a dose of 300mg once daily for three months. This gives a better compliance and lower the risk of drug induced side effects. doi: https://doi.org/10.12669/pjms.35.6.990 How to cite this:Loya H, Ghoghari H, Rizvi SF, Khan A. Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy. Pak J Med Sci. 2019;35(6):1687-1690. doi: https://doi.org/10.12669/pjms.35.6.990 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 45%

Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

Loya¹,

Ghoghari²,

Rizvi³

et al. 2019

Pak J Med Sci

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“…Drug-induced hepatotoxicity has been reported following treatment with rifampicin in CSCR. 10 No serious adverse events were noted in our series that required discontinuation of treatment. One of the major concerns with the use of rifampicin in chronic CSCR is the development of drug resistance.…”

Section: Discussionmentioning

confidence: 61%

Efficacy of oral rifampicin in chronic central serous chorioretinopathy

2018

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Objective:To evaluate the role of oral rifampicin in the management of chronic central serous chorioretinopathy.Methods:Retrospective analysis of patients diagnosed with chronic central serous chorioretinopathy (duration >3 months) and treated with oral rifampicin 600 mg daily for a maximum period of 3 months was carried out. Baseline visual acuity, fundus fluorescein angiography, and optical coherence tomography were recorded and the patients were followed up. Resolution of subretinal fluid and improvement in visual acuity were the main outcome measures. Recurrence of subretinal fluid was noted. Any adverse reaction to the drug was monitored.Results:Nine eyes of eight patients were included in the study. The average age of the patients was 41.90 years (range 32–52 years). Mean duration of symptoms was 16 months (range 3–60 months). Mean duration of follow-up was 10.11 months (range 3–33 months). Fluorescein angiography showed four eyes with subfoveal leaks and five eyes with diffuse retinal pigment epitheliopathy. Complete resolution of subretinal fluid was achieved in four of the nine eyes – two patients at the end of 1 month, one patient each at the end of 2 and 3 months, respectively. Visual acuity improvement was noted in four of the nine eyes. Three patients had one-line improvement and one patient had a two-line visual improvement. None of the patients had severe adverse events for which the drug had to be discontinued. None of the patients had recurrence of subretinal fluid after the discontinuation of the drug.Conclusion:Oral rifampicin could provide a useful, effective, and cost-effective alternative for treatment of patients with chronic central serous choroidopathy and evidence of healthier retinal pigment epithelium, those with focal leakage. It was not effective in eyes with diffuse retinal pigment epitheliopathy.

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“…26 It should also be noted that one patient treated with rifampin for CSC was reported to develop hepatotoxicity. 50 Reduction of CMT and improvement in VA was reported with the antimineralocorticoids, but it should be noted that these agents can cause low blood pressure, hyperkalemia, and other adverse effects. [43][44][45][46][47][48] Acetazolamide was shown to reduce CMT but had no effect on VA, and it too can cause low blood pressure and other adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Finasteride is effective for the treatment of central serous chorioretinopathy

Moisseiev

Holmes

Moshiri

et al. 2016

Eye

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Purpose To evaluate the safety and efficacy of finasteride treatment in patients with central serous chorioretinopathy (CSC). Methods Retrospective review of 29 eyes of 23 patients who were treated with finasteride for CSC. Previous medical and ocular history, steroid use, length of finasteride treatment, additional treatments for CSC, visual acuity (VA), central macular thickness (CMT), and presence of subretinal fluid (SRF) throughout the follow-up period, and the occurrence of any complications were recorded. Results Initial VA was 0.29 ± 0.31 logMAR, and a trend towards improved VA was noted after 3 months (0.25 ± 0.36 logMAR; P = 0.07). VA was significantly improved at the final follow-up (0.23 ± 0.27 logMAR; P = 0.024). Initial CMT was 354 ± 160 μm, and was significantly reduced after 1 month of treatment (284 ± 77 μm; P = 0.002) and this was maintained to the end of follow-up (247 ± 85 μm; P = 0.001). A significant reduction in SRF presence was found at all time points, with an overall 75.9% rate of complete resolution. Following discontinuation, SRF recurrence was noted in 37.5% of cases. No adverse events were recorded. Conclusions Finasteride is a safe and effective treatment for CSC. It may be a possible new option for the initial management of patient with CSC, and a suggested treatment approach is presented.

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Rifampin Induced Hepatotoxicity During Treatment for Chronic Central Serous Chorioretinopathy

Abstract: Rifampin-induced hepatic injury can occur during therapy for chronic central serous chorioretinopathy. Potential hepatotoxicity must be considered and followed closely during off-label rifampin treatment.

Cited by 15 publications

References 18 publications

Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

Efficacy of oral rifampicin in chronic central serous chorioretinopathy

Finasteride is effective for the treatment of central serous chorioretinopathy

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