Ahmet ELBAY, Alper YENİGÜN, Hakan ÖZDEMİR, Ömer Faruk ÇALIM, Cansu EKİNCİ, Rukiye ÇETİNKAYA

Kortikosteroid içerikli burun spreyi kullanımının santral seröz koryoretinopati gelişiminde rolü var mı?

Amaç: Bu çalışmanın amacı kortikosteroid içerikli burun spreyi kullanımının santral seröz koryoretinopati (SSR) gelişimine ve koroid ve retina pigment epiteli - Bruch membran kompleksi (RPE-BM) kalınlığı üzerine etkisini araştırmaktır.Gereç ve Yöntemler: Çalışmaya mometazon içerikli burun spreyi tedavisi başlanan 29 hasta (18 kadın, 11 erkek) dahil edildi. Hastaların ilaç kullanımından önce ve ilaç kullanmaya başladıktan bir hafta ve bir ay sonra sistolik kan basıncı (SKB), diastolik kan basıncı (DKB), görme keskinliği, göz içi basıncı ile koroid ve RPE-BM kalınlıkları ölçüldü. Optik koherens tomografi kesitleri SSR gelişimi açısından incelendi. Ölçümler sağ gözden yapıldı.Bulgular: Tedavi sonrası hiçbir hastada SSR saptanmadı. Ortalama koroid kalınlığı ölçümlerinde başlangıç değerlerle kontrol muayenelerindeki ölçümler arasında istatistiksel olarak anlamlı değişiklikler saptanmadı: Temporal tarafta başlangıçta 292,48±73,02 µm, 1. haftada 296,83±79,09 µm, 1. ayda 295,41±74,13 µm (p = 0,405); fovea altında başlangıçta 360,62±92,44 µm, 1. haftada 364,04±93,65 µm, 1. ayda 365,66±95,86 µm (p = 0,208); nasal tarafta başlangıçta 282,86±96,11 µm, 1. haftada 285,28±93,25 µm, 1. ayda 284,28±98,14 µm (p = 0,819), RPE-BM başlangıçta 21,65±2,86 µm iken 1. haftada 21,24±2,61 µm, 1. ayda ise 21,58±2,09 µm olarak ölçüldü. Farklılıklar istatistiksel olarak anlamlı değildi (p = 0,450). Göz içi basıncı (p = 0,450), SKB (p = 0,257) ve DKB (p = 0,249) ölçümlerinde de anlamlı fark saptanmadı. Tartışma ve Sonuç: Kortikosteroid kaynaklı SSR insidansını incelemek için ve SSR gelişimi ile koroid ya da RPE-BM kalınlığı arasında bir ilişki olup olmadığını kesin olarak belirlemek için daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Santral seröz koryoretinopati, koroid kalınlığı, retina pigment epiteli – Bruch membran kompleksi, kortikosteroid, nasal sprey

Does the use of corticosteroid nasal spray play a role in the development of central serous chorioretinopathy?

Aim: The aim of the present study is to investigate the effect of corticosteroid-containing nasal spray on development of central serous chorioretinopathy (CSC) development and thickness of choroid and Retinal pigment epithelium-Bruch membrane complex (RPE-BM). Materials and Methods: Twenty-nine patients (18 female, 11 male) receiving nasal mometasone spray were included in the study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), visual acuity, intraocular pressure and choroidal and RPE-BM thicknesses were measured before and one week and one month after drug administration. Optical coherence tomography sections were examined in terms of CSCdevelopment. Measurements were made from the right eye.Results: Central serous chorioretinopathy was not detected in any of the patients. Mean choroidal thickness measurements did not show any statistically significant changes between baseline values and follow-up measurements: On the temporal side 292.48±73.02 μm before the treatment, 296.83±79.09 μm at the first week, 295.41±74.13 μm at the first month (p = 0.405); at the subfovea 360.62±92.44 μm at baseline, 364.04±93.65 μm at the first week, and 365.66±95.86 μm at the first month (p = 0.208) under the fovea; on the nasal side, 282.86±96.11 μm at the beginning, 285.28±93.25 μm at the first week and 284.28±98.14 μm at the first month (p = 0.819). RPE-BM was measured as 21.65±2.86 μm at the beginning, 21.24±2.61 μm at the first week and 21.58±2.09 μm at the first month. Differences were not statistically significant (p = 0.450). There was no significant difference in intraocular pressure (p = 0.450), SBP (p = 0.257) and DBP (p = 0.249) measurements. Discussion and Conclusion: Further studies are needed to determine the incidence of corticosteroid-induced SSR and cause-effect relationship between CSC development and choroid or RPE-BM thickness.

Keywords:

Central serous chorioretinopathy, choroidal thickness, retinal pigment epithelium-Bruch membrane complex, corticosteroid, nasal spray,

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