摘要多数中心性浆液性脉络膜视网膜病变(CSC)患者在急性发病后4～6个月可自行好转;而大约有30％～50％的患者出现慢性病程,常出现持续性视网膜下液及复发性或持续性神经上皮脱离,对视力造成严重影响.盐皮质激素受体(MR)是一种核激素受体,通过与包括醛固酮、皮质醇等在内的多重配体作用,参与水电解质平衡、炎症反应等.MR被过度激活与许多疾病有关.研究发现,MR拮抗剂治疗慢性CSC有明显疗效,可降低视网膜厚度,提高视力,且治疗及随访期间未发生严重不良反应.临床多采用MR拮抗剂初始给药剂量为25 mg/d口服,在1周后增加至50 mg/d,治疗疗程多为3个月,但尚未明确最佳治疗剂量及疗程.MR拮抗剂可能是治疗慢性CSC安全有效的治疗方法,但目前研究证据尚不足,有待更多大样本随机对照研究加以验证.

abstractsAs most patients of central serous retinopathy (CSC),the symptoms of acute onset will alleviate by oneself after 4-6 months.About 30％-50％ of patients with CSC experience chronic or recurrent cases.Resulting in persistent neurosensory detachments and subretinal fluid,causing significant vision loss.Mineralocorticoid receptor (MR) is a kind of nuclear hormone receptors,plays a role in theregulation of water and electrolyte balance.Excessive MR signaling is associated with many diseases.Study found that MR antagonists decreased the thickness of the retina and improved in vision,there was no serious adverse reactions during the period of treatment.Initial dose of MR antagonists was 25 mg per day,1 week later,dosage was increased to 50 mg per day,and treatment for about 3 months.There is no conclusive effective treatment and the dosage are still unknown.MR antagonists may be a safe and effective way to treat CSC,though evidence is scant.Prospective,multicenter,large-scale trials is required.