Central serous chorioretinopathy in primary hyperaldosteronism

作者：van Dijk Elon H C; Nijhoff Michiel F; de Jong Eiko K; Meijer Onno C; de Vries Aiko P J; Boon Camiel J F^*

来源：Graefes Archive for Clinical and Experimental Ophthalmology, 2016, 254(10): 2033-2042.

DOI：10.1007/s00417-016-3417-8

• Central serous chorioretinopathy
• Eplerenone
• Hyperaldosteronism
• Mineralocorticoid antagonist
• Cross-sectional study
• Spironolactone

Purpose To describe ophthalmological characteristics of 13 patients with primary hyperaldosteronism (PA).
Methods Cross-sectional study. All patients underwent extensive ophthalmological examination.
Results Thirteen PA patients (9 male, 4 female) were diagnosed with arterial hypertension for 11.0 +/- 11.2 years. Ophthalmological imaging revealed macular serous subretinal fluid (SRF) on optical coherence tomography in 2 patients (15 %). In one of these patients, bilateral chronic central serous chorioretinopathy (CSC) with polypoidal choroidal neovasculopathy was diagnosed, which was effectively treated with full-dose photodynamic therapy. In the other patient with SRF and bilateral diffuse hyperfluorescent areas on fluorescein angiography, the SRF had decreased spontaneously after 6 weeks of follow-up. In 5 of the remaining patients (38 %), retinal pigment epithelium alterations resembling findings characteristic for CSC were seen on multimodal imaging. The mean subfoveal choroidal thickness was 290.2 +/- 65.0 mu m.
Conclusions Retinal abnormalities resembling (subclinical) CSC are common in patients with PA. These findings indicate that mineralocorticoid-mediated pathways are involved in the pathogenesis of CSC. In CSC patients with hypertension of unknown origin, a diagnosis of PA should be considered.

• 出版日期2016-10