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Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration

INTRODUCTION: The purpose of this project was to evaluate the role of MR antagonists as an adjunct in patients with neovascular age-related macular degeneration (AMD) who have chronic subretinal fluid. METHODS: Inclusion criteria were patients with a diagnosis of neovascular AMD, who had completed a...

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Autores principales: Kapoor, Kapil G., Todi, Niket, Wagner, Alan L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449294/
https://www.ncbi.nlm.nih.gov/pubmed/27900561
http://dx.doi.org/10.1007/s40123-016-0075-1
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author Kapoor, Kapil G.
Todi, Niket
Wagner, Alan L.
author_facet Kapoor, Kapil G.
Todi, Niket
Wagner, Alan L.
author_sort Kapoor, Kapil G.
collection PubMed
description INTRODUCTION: The purpose of this project was to evaluate the role of MR antagonists as an adjunct in patients with neovascular age-related macular degeneration (AMD) who have chronic subretinal fluid. METHODS: Inclusion criteria were patients with a diagnosis of neovascular AMD, who had completed at least six anti-VEGF injections, and had persistent subretinal fluid (SRF) on optical coherence tomography (OCT). Treatment with oral eplerenone was initiated and dose titrated according to protocol. RESULTS: 23 patients were included in the study (mean age = 54.6, 52.2% female, 47.8% male). 13 of the 23 patients had predominantly chronic subretinal fluid without large PEDs. In this subgroup, mean initial central macular thickness (CMT) prior to starting oral eplerenone was 305.3 μm, and mean injection interval was 40.25 days. Mean final CMT after at least 3 months of adjunctive eplerenone treatment was 240.6 μm and mean injection interval with adjunctive treatment was 54.61 days. Mean extension of the injection interval after commencing oral eplerenone was 14.36 days. CONCLUSIONS: These findings suggest oral MR antagonists may have a role as an adjunctive treatment in neovascular AMD, and may be particularly useful in dehydration of the subretinal space in the setting of chronic subretinal fluid. Further research is needed in randomized controlled trials to elucidate the precise role of oral MR antagonists in neovascular AMD.
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spelling pubmed-54492942017-06-15 Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration Kapoor, Kapil G. Todi, Niket Wagner, Alan L. Ophthalmol Ther Original Research INTRODUCTION: The purpose of this project was to evaluate the role of MR antagonists as an adjunct in patients with neovascular age-related macular degeneration (AMD) who have chronic subretinal fluid. METHODS: Inclusion criteria were patients with a diagnosis of neovascular AMD, who had completed at least six anti-VEGF injections, and had persistent subretinal fluid (SRF) on optical coherence tomography (OCT). Treatment with oral eplerenone was initiated and dose titrated according to protocol. RESULTS: 23 patients were included in the study (mean age = 54.6, 52.2% female, 47.8% male). 13 of the 23 patients had predominantly chronic subretinal fluid without large PEDs. In this subgroup, mean initial central macular thickness (CMT) prior to starting oral eplerenone was 305.3 μm, and mean injection interval was 40.25 days. Mean final CMT after at least 3 months of adjunctive eplerenone treatment was 240.6 μm and mean injection interval with adjunctive treatment was 54.61 days. Mean extension of the injection interval after commencing oral eplerenone was 14.36 days. CONCLUSIONS: These findings suggest oral MR antagonists may have a role as an adjunctive treatment in neovascular AMD, and may be particularly useful in dehydration of the subretinal space in the setting of chronic subretinal fluid. Further research is needed in randomized controlled trials to elucidate the precise role of oral MR antagonists in neovascular AMD. Springer Healthcare 2016-11-29 2017-06 /pmc/articles/PMC5449294/ /pubmed/27900561 http://dx.doi.org/10.1007/s40123-016-0075-1 Text en © The Author(s) 2016 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Kapoor, Kapil G.
Todi, Niket
Wagner, Alan L.
Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title_full Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title_fullStr Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title_full_unstemmed Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title_short Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration
title_sort mineralocorticoid antagonists as adjuncts in neovascular age-related macular degeneration
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449294/
https://www.ncbi.nlm.nih.gov/pubmed/27900561
http://dx.doi.org/10.1007/s40123-016-0075-1
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