EFFECTS OF SUBTENON-INJECTED AUTOLOGOUS PLATELET-RICH PLASMA AND ORAL SPIRONOLACTONE ON VISUAL FUNCTIONS IN EYES WITH ACUTE CSRS

The purpose of this study was to determine if subtenon injections of autologous platelet-rich plasma (aPRP) combined with oral spironolactonae can have beneficial effects on visual function in CSRS patient.

University Center Clinic of Kosova,Eye Clinic.

A 48-year-old man presented of decreasing central vision with floaters in both eyes. His visual acuity at that visit was OD 20/30 and OS 20/-30 . His past medical history was significant for 3 recent steroid injections in her back..  Patient was treated with spironolactone 50 mg once daily  for up to 12 weeks. Follow-up examinations with BCVA, OCT, were performed at 1, 2, and 3 months after starting the treatment. Main outcome measure was a change of subretinal fluid (SRF) (in micrometers) measured by optical coherence tomography. Secondary outcome was a change in central retinal thickness (CRT) (in micrometers) measured by OCT and a change in BCVA. Subtenon PRP injections were applied on the 1st, 7th and 14th days  of the 21-day therapy (a total of three injections). Responses to treatment were evaluated in the first month after the procedures.

After 1 month, subretinal fluid was regressing only slightly, so the dose was increased to 50 mg p.o. b.i.d.  One month later, all subretinal fluid had resolved. Visual acuity had improved to 20/20.Due to improvements, the patient was slowly tapered off spironolactone to 50 mg p.o. once.i.d. with 1 month of follow-up. On the next follow-up, he continued to remain stable, so the spironolactone was tapered to 25 mg once a day. 

The subtenon injection of aPRP seems to be a therapeutic option for treatment and might lead to positive results in the vision of CRS patients.Our case report  could confirm a positive influence of spironolactone on the course CSC. Longer follow-up with a larger number of cases could provide more data about the long-term efficiency, recurrences, and safety of this well-tolerated and non-invasive treatment option of CSC.