Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone

Abstract

Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P = 0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P = 0.010). There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

Comparison of long-term clinical evolution in highly myopic eyes with vertical oval-shaped dome with or without untreated serous retinal detachment

“…Taking these facts into account, it is difficult to understand validated therapy leading to the resolution of serous retinal detachment related to dome-shaped macula. For example, laser photocoagulation,8 photodynamic therapy,13 15 antivascular endothelial grown factor13 and spironolactone24 therapy have all been tried with inconclusive results. Bearing in mind that spontaneous resolution is possible in this pathology, some researchers have recommended observation without treatment 3 15 25.…”

Epiretinal Membrane in Dome-Shaped Macula Complicated with Serous Retinal Detachment: Transient Efficacy of Surgery

“…Several studies showed the presence of SRD in patients presenting with DSM [ 1 , 2 , 6 , 7 , 8 ]. Different hypotheses were advanced to explain SRD appearance.…”

Dome-shaped macula phenomenon

“…А. Sanz et al также продемонстрировали эффек-тивность данного препарата: в дозе 50 мг в тече-ние 6 мес. на 14 глазах 12 пациентов [28]. P. Rocha Cabrera et al, в свою очередь, показали эффек-тивность данного вида лечения [27].…”