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Midori Araki, Tsutomu Yasukawa, Masayuki Ashikari, Aki Kato, Nana Tachi, Yoshio Hirano, Yuichiro Ogura; Long-Term Impacts of Antioxidant Supplementation and Smoking Cessation on Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6372.
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© ARVO (1962-2015); The Authors (2016-present)
Chronic central serous chorioretinopathy (CSC) has persistent serous retinal detachment (sRD), resulting in gradual vision loss. We have previously reported the potential of antioxidant supplementation and smoking cessation to enhance spontaneous remission of chronic CSC (Tachi et al, ARVO, 2011). The purpose of this study is to evaluate the long-term prognosis of chronic CSC with spontaneous remission under smoking cessation and antioxidant supplementation.
Nineteen eyes of 17 patients, who were diagnosed as chronic CSC and guided to stop smoking, if they were a current smoker, and take antioxidant supplements produced on the basis of AREDS formulation (Ocuvite® Lutein or Sante Lutax® 15), were enrolled. Nine patients were a current smoker, 7 an experienced smoker, and 3 a nonsmoker. Averaged age was 59.4 ± 11.5 years. Mean follow-up period was 54 ± 3.9 months. Rate of remission and relapsing of sRD and best-corrected visual acuity (BCVA) were assessed.
Spontaneous remission of sRD was observed in 16 of 19 eyes (84%) with mean duration of 4.6 ± 0.53 months. Of these eyes, 7 eyes (37%) had no recurrence during the observation period, while 9 eyes (47%) had remitting and relapsing of chronic CSC. In 2 eyes, relapsing was observed immediately after resuming smoking. At the last visit, 4 eyes of 9 remitting-relapsing cases had no sRD and 5 eyes had recurred sRD. In the other 3 eyes (16%), sRD persisted without remission. Five eyes underwent any interventional treatment 30 ± 10 months after life style guidance in average. Mean BCVA in the LogMAR unit in 14 eyes without any treatments was significantly improved from 0.22 ± 0.10 at baseline to 0.11 ± 0.07 at the last visit (p<0.05). Improvement of BCVA with 0.3 or more LogMAR units was obtained in 3 eyes (21%), while no eyes deteriorated BCVA. Mean BCVA of 5 eyes with interventional treatments was significantly improved from 0.24 ± 0.16 at baseline to 0.07 ± 0.13 at the last visit (P<0.05).
The current study suggested that antioxidant supplementation and smoking cessation might enhance spontaneous remission and reduce relapsing rate in eyes with chronic CSC over 5 years. Delay of interventional treatments was unlikely to worsen the prognosis of chronic CSC. Lifestyle guidance might be worthwhile for patients with chronic CSC before therapeutic intervention was considered.
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