Author: Sandra Gomez Perera
Co-authors: Hugo E Tapia Quijada, Rocio Falcon Roca, Carla Arteaga Henriquez, Sara Rodriguez Marrero
Abstract
Purpose: To describe a case of serous detachment of the central neurosensory retina (DNS) in a patient with chronic central serous chorioretinopathy (CSC) who obtained fluid remission after treatment with finasteride.Methods: Case report
Results : A 58-year-old male presented with complaints of decreased vision in the right eye (RE). The patient was taking potassium citrate (acalka 1080 mg) for kidney stones. As background, he had a diagnosis of CSC that had been treated several years ago with photodynamic therapy (PDT) in another center and had presented stability after this treatment. In the current episode, 6 months ago, she has presented a progressive visual decrease in her RE with a diagnosis of recurrence of the picture in the RE. His best corrected visual acuity was 0.4 in RE and 1.0 in LE. The biomicroscopic examination of the anterior segment of the eyes was normal, the eye fundus examination revealed alterations of the retinal pigment epithelium. OCT showed serous neurosensory retinal detachment (NSD) and an irregular flat PED, the foveal thickness was 506um. New treatment with PDT was considered but it was not possible due to lack of verteporfin. Treatment with eplerenone was contraindicated due to the risk of hyperkalaemia due to chronic treatment of acalka. An angiography study was performed that did not show extrafoveal leak points to attempt focal laser treatment. In this context, the patient had undergone hair treatment and had recently started finasteride as a treatment for hair loss. In the review 3 months after starting fiasteride, a complete remission of the DNS with GF of 210um and an BCVA of 1.0 was evidenced.
Conclusions: Spontaneous improvement of DNS is very rare in the context of chronic CSC like that of our patient. Therefore, the finasteride (antiandrogenic) that the patient takes as a hair treatment (for hair loss) would be responsible for the remission of the DNS in this case of chronic CSC.
