logo
Volume 6, Issue 1 (6-2024)                   pbp 2024, 6(1): 1-9 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Samadi N, Motarjemizadeh G, Moharmzadeh N. Therapeutic Effects of Low Dose Acetylsalicylic Acid on Acute Central Serous Chorioretinopathy: A Prospective, Interventional, Single Centre Case Series. pbp 2024; 6 (1) :1-9
URL: http://pbp.medilam.ac.ir/article-1-214-en.html
1- Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2- Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran , drkadirmurathan@gmail.com
Abstract:   (667 Views)
Objective: Central serous chorioretinopathy (CSCR) is a common cause of central vision loss, primarily affecting men 20–60 years of age. This study aimed to investigate the efficacy of low-dose aspirin for the treatment of acute CSCR.
Methods: Totally 60 patients (60 eyes) with a history of acute CSC on fenofibrate were randomized into two groups: group A was treated with aspirin 100 mg per day orally for 1 month followed by 100 mg on alternate days for 5 months by evaluation of visual acuity, mean subretinal fluid vertical diameter (SFVD), Optical Coherence Tomography (OCT), and central macular thickness (CMT) at baseline and follow up period.  Group B received no medication and was considered as the control group. Follow-up times were the first week, 1, 2, 3 and 6 months after treatment initiation.
Results: No differences were seen between the studied groups in terms of baseline BCVA (P = 0.968) and baseline SFVD (P = 0.774). BCVA improved, and SFVD was reduced significantly in the group A at all follow-up intervals compared with baseline values. Aspirin intervention (group A), compared with no intervention group (group B), was statistically more effective in improving BCVA (P < 0.001) and in reducing SFVD (P < 0.001) after 6 months. While 93.3% (n=28) of Group A’s cases had no recurrences during the follow-up period, only 60.0% (n=18) of patients in the group B had a resolution of CSCR with no recurrences.
Conclusion: More rapid visual rehabilitation with fewer recurrences of CSCR were detected in the group A than in group B. These results demonstrated that orally administered aspirin may be a promising option for selected patients in the treatment of acute CSCR.
Full-Text [PDF 2463 kb]   (72 Downloads)    
Type of Study: Research | Subject: Clinical
Received: 2024/02/17 | Accepted: 2024/02/20 | Published: 2024/02/20

References
1. Liegl R, Ulbig MW. Central serous chorioretinopathy. Ophthalmologica. 2014; 232(2):65-76. doi: 10.1159/000360014.
2. Iacono P, Battaglia PM, Papayannis A, La Spina C, Varano M, Bandello F. Acute central serous chorioretinopathy: a correlation study between fundus autofluorescence and spectral-domain OCT. Graefe's Archive for Clinical and Experimental Ophthalmology. 2015;253:1889-97. doi: 10.1007/s00417-014-2899-5.
3. Van Rijssen TJ, van Dijk EH, Scholz P, Breukink MB, Dijkman G, Peters PJ, et al. Long‐term follow‐up of chronic central serous chorioretinopathy after successful treatment with photodynamic therapy or micropulse laser. Acta Ophthalmologica. 2021;99(7):805-11. doi: 10.1111/aos.14775.
4. Breukink MB, Dingemans AJ, den Hollander AI, Keunen JE, MacLaren RE, Fauser S, Querques G, Hoyng CB, Downes SM, Boon CJ. Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life. Clin Ophthalmol. 2016;11:39-46. doi: 10.2147/OPTH.S115685.
5. Islam QU, Farooq MA, Mehboob MA. Factors affecting the visual outcome in acute central serous chorioretinopathy. Pak J Med Sci. 2017;33(1):3-7. doi: 10.12669/pjms.331.11664.
6. Caccavale A, Romanazzi F, Imparato M, Negri A, Morano A, Ferentini F. Central serous chorioretinopathy: a pathogenetic model. Clin Ophthalmol. 2011;5:239-43. doi: 10.2147/OPTH.S17182.
7. Liegl R, Ulbig MW. Central serous chorioretinopathy. Ophthalmologica. 2014;232(2):65-76. doi: 10.1159/000360014.
8. Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41(2):201-14. doi: 10.1111/j.1442-9071.2012.02848.x.
9. Caccavale A, Romanazzi F, Imparato M, Negri A, Morano A, Ferentini F. Low-dose aspirin as treatment for central serous chorioretinopathy. Clin Ophthalmol. 2010;4:899-903. doi: 10.2147/opth.s12583.
10. Peters JM, Shah YM, Gonzalez FJ. The role of peroxisome proliferator-activated receptors in carcinogenesis and chemoprevention. Nat Rev Cancer. 2012;12(3):181-95. doi: 10.1038/nrc3214.
11. Yoon BK, Kang YH, Oh WJ, Lee DY, Kim DK, Kessel B, Kang CD. Effects of 17β-Estradiol on the Plasminogen Activator System in Vascular Smooth Muscle Cells Treated with Lysophophatidylcholine. J Menopausal Med. 2020;26(1):9-17. doi: 10.6118/jmm.19005.
12. Kasetti RB, Maddineni P, Patel PD, Searby C, Sheffield VC, Zode GS. Transforming growth factor β2 (TGFβ2) signaling plays a key role in glucocorticoid-induced ocular hypertension. J Biol Chem. 2018;293(25):9854-9868. doi: 10.1074/jbc.RA118.002540.
13. Hale SA, Sobel B, Benvenuto A, Schonberg A, Badger GJ, Bernstein IM. Coagulation and Fibrinolytic System Protein Profiles in Women with Normal Pregnancies and Pregnancies Complicated by Hypertension. Pregnancy Hypertens. 2012;2(2):152-157. doi: 10.1016/j.preghy.2012.01.004.
14. Cheng W, Liao Y, Xie Y, Wang Q, Li L, Chen Y, Zhao Y, Zhou J. Helicobacter pylori-induced fibroblast-derived Serpin E1 promotes gastric cancer growth and peritoneal dissemination through p38 MAPK/VEGFA-mediated angiogenesis. Cancer Cell International. 2023;23(1):326. doi: 10.1186/s12935-023-03177-1.
15. Mennesson M, Revest JM. Glucocorticoid-Responsive Tissue Plasminogen Activator (tPA) and Its Inhibitor Plasminogen Activator Inhibitor-1 (PAI-1): Relevance in Stress-Related Psychiatric Disorders. Int J Mol Sci. 2023;24(5):4496. doi: 10.3390/ijms24054496.
16. Party H, Dujarrier C, Hébert M, Lenoir S, Martinez de Lizarrondo S, Delépée R, et al. Plasminogen Activator Inhibitor-1 (PAI-1) deficiency predisposes to depression and resistance to treatments. Acta Neuropathol Commun. 2019;7(1):153. doi: 10.1186/s40478-019-0807-2.
17. Sogutlu Sari E, Yazici A, Eser B, Erol MK, Kilic A, Ermis SS, et al. The prevalence of 4G/5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene in central serous chorioretinopathy and its association with plasma PAI-1 levels. Cutan Ocul Toxicol. 2014;33(4):270-4. doi: 10.3109/15569527.2013.854372.
18. Liu H, Pietersz G, Peter K, Wang X. Nanobiotechnology approaches for cardiovascular diseases: site-specific targeting of drugs and nanoparticles for atherothrombosis. J Nanobiotechnology. 2022;20(1):75. doi: 10.1186/s12951-022-01279-y.
19. Bagoly Z, Szegedi I, Kálmándi R, Tóth NK, Csiba L. Markers of Coagulation and Fibrinolysis Predicting the Outcome of Acute Ischemic Stroke Thrombolysis Treatment: A Review of the Literature. Front Neurol. 2019;10:513. doi: 10.3389/fneur.2019.00513.
20. Alsmman AH, Mostafa EM, Mounir A. Combined Argon Laser and Low Dose Acetylsalicylic acid in Treatment of Acute Central Serous Chorioretinopathy. Med Hypothesis Discov Innov Ophthalmol. 2018;7(3):126-132. PMID: 30386802; PMCID: PMC6205675.
21. Leisser C, Hirnschall N, Hackl C, Plasenzotti P, Findl O. Eplerenone in patients with chronic recurring central serous chorioretinopathy. Eur J Ophthalmol. 2016;26(5):479-84. doi: 10.5301/ejo.5000727.
22. Chan WM, Liu DT, Chan CK, Wong BW, Tam PM, Lam DS. Peripheral retinal neovascularization in bullous central serous chorioretinopathy. Eye (Lond). 2004;18(12):1275-7. doi: 10.1038/sj.eye.6701399.
23. Stalmans P, Duker JS, Kaiser PK, Heier JS, Dugel PU, Gandorfer A, Sebag J, Haller JA. Oct-based interpretation of the vitreomacular interface and indications for pharmacologic vitreolysis. Retina. 2013;33(10):2003-11. doi: 10.1097/IAE.0b013e3182993ef8.
24. Liu P, Fang H, An G, Jin B, Lu C, Li S, et al. Chronic Central Serous Chorioretinopathy in Elderly Subjects: Structure and Blood Flow Characteristics of Retina and Choroid. Ophthalmol Ther. 2024;13(1):321-335. doi: 10.1007/s40123-023-00849-z.
25. Agarwal A. Gass’ atlas of macular diseases. 5th ed. Elsevier; 2011.
26. Mehta PH, Chhablani J, Wang J, Meyerle CB. Central Serous Chorioretinopathy in African Americans at Wilmer Eye Institute. J Natl Med Assoc. 2018;110(3):297-302. doi: 10.1016/j.jnma.2017.06.012.
27. Maruko I, Iida T, Ojima A, Sekiryu T. Subretinal dot-like precipitates and yellow material in central serous chorioretinopathy. Retina. 2011;31(4):759-65. doi: 10.1097/IAE.0b013e3181fbce8e.
28. Prakash G, Chauhan N, Jain S, Satsangi SK. Central Serous Chorioretinopathy: A Review of the Literature. Asia Pac J Ophthalmol (Phila). 2013;2(2):104-10. doi: 10.1097/APO.0b013e31829069ee.
29. Sartini F, Menchini M, Posarelli C, Casini G, Figus M. Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review. Pharmaceuticals (Basel). 2020;13(9):221. doi: 10.3390/ph13090221.
30. Stefaniotou M, Vourda E, Katsanos A, Aspiotis M. Multifocal central serous chorioretinopathy associated with steroids in a patient with myasthenia gravis. Case Rep Ophthalmol. 2013;4(2):1-6. doi: 10.1159/000351856.
31. Bujarborua D, Nagpal PN, Deka M. Smokestack leak in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2010;248(3):339-51. doi: 10.1007/s00417-009-1212-5.
32. Feenstra HMA, van Dijk EHC, van Rijssen TJ, Tsonaka R, Diederen RMH, Hoyng CB, et al. Long-term follow-up of chronic central serous chorioretinopathy patients after primary treatment of oral eplerenone or half-dose photodynamic therapy and crossover treatment: SPECTRA trial report No. 3. Graefes Arch Clin Exp Ophthalmol. 2023;261(3):659-668. doi: 10.1007/s00417-022-05836-x.
33. Abouammoh MA. Advances in the treatment of central serous chorioretinopathy. Saudi J Ophthalmol. 2015;29(4):278-86. doi: 10.1016/j.sjopt.2015.01.007.
34. Kim YY, Flaxel CJ. Factors influencing the visual acuity of chronic central serous chorioretinopathy. Korean J Ophthalmol. 2011;25(2):90-7. doi: 10.3341/kjo.2011.25.2.90.
35. Wang Y, Wang W, Wang B, Wang Y. The Risk of Gastrointestinal Hemorrhage in Low-Dose Aspirin Users with Diabetes Mellitus: Systematic Review and Meta-Analysis. Gastroenterol Res Pract. 2020;2020:9824615. doi: 10.1155/2020/9824615.
36. Does aspirin affect the rate of cataract formation? Cross-sectional results during a randomised double-blind placebo controlled trial to prevent serious vascular events. UK-TIA Study Group. Br J Ophthalmol. 1992;76(5):259-61. doi: 10.1136/bjo.76.5.259.
37. Jeng CJ, Hsieh YT, Lin CL, Wang IJ. Effect of anticoagulant/antiplatelet therapy on the development and progression of diabetic retinopathy. BMC Ophthalmol. 2022;22(1):127. doi: 10.1186/s12886-022-02323-z.
38. Zhang W, Liu H, Rojas M, Caldwell RW, Caldwell RB. Anti-inflammatory therapy for diabetic retinopathy. Immunotherapy. 2011;3(5):609-28. doi: 10.2217/imt.11.24.
39. Liu Z, Li G, Ma Y, Lin L. The Effects of Aspirin With Combined Compound Danshen Dropping Pills on Hemorheology and Blood Lipids in Middle-Aged and Elderly Patients With CHD: A Systematic Review and Meta-Analysis. Front Public Health. 2021;9:664841. doi: 10.3389/fpubh.2021.664841.
40. De La Cruz JP, Del Río S, López-Villodres JA, Villalobos MA, Jebrouni N, González-Correa JA. Virgin olive oil administration improves the effect of aspirin on retinal vascular pattern in experimental diabetes mellitus. Br J Nutr. 2010;104(4):560-5. doi: 10.1017/S0007114510000929.
41. Nowak JZ. Aspirin and age-related macular degeneration: positives versus negatives. Expert Opin Drug Saf. 2014;13(6):687-90. doi: 10.1517/14740338.2014.915939.
42. Liew G, Mitchell P, Wong TY, Rochtchina E, Wang JJ. The association of aspirin use with age-related macular degeneration. JAMA Intern Med. 2013;173(4):258-64. doi: 10.1001/jamainternmed.2013.1583.
43. Klein R, Myers CE, Lee KE, Gangnon RE, Sivakumaran TA, Iyengar SK, Klein BE. Small Drusen and Age-Related Macular Degeneration: The Beaver Dam Eye Study. J Clin Med. 2015;4(3):424-40. doi: 10.3390/jcm4030425.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.