Effect of half adult dose of oral Rifampicin (300mg) in patientswith idiopathic central serous chorioretinopathy

Abstract

Objectives:To evaluate the effect of half adult dose of oral Rifampicin on mean change in best corrected visual acuity and central macular thickness in patients with central serous chorioretinopathy.Methods:Thirty-eight eyes of 31 patients with idiopathic central serous chorioretinopathy (CSCR) were registered. Unaided Visual acuity, best corrected visual acuity was documented and detailed slit lamp examination along with dilated ophthalmoscopy was performed. All subjects were treated with oral Rifampicin 300 mg (half adult dose) daily for 03 months. Patients underwent a complete ocular and systemic examination as well as central macular thickness (CMT) measurement by optical coherence tomography (OCT) every month after starting treatment until four months. Fundus fluorescein angiography (FFA) was performed in recurrent cases. Liver function tests were carried out prior to the treatment and during follow up period.Results:A total of 38 eyes of 31 patients (24 males, 07 females) were included in the study. Mean age of patients was 36.16±3.19 years (range 30-44). Mean best corrected visual acuity (BCVA) before treatment was 0.56±0.11 and improved to 0.47±0.14 at 04 weeks (P<0.001) of treatment. The mean CMT at the time of presentation was 494.39±96.29 um and was decreased to 306.90±50.71 um after 04 weeks of treatment (P<0.001). The mean induced reduction in CMT was 187.48±122 um (P<0.001) while that in BCVA 0.41±0.16 at 04 weeks of treatment (P<0.001). Liver function tests were within normal range before and after the treatment.Conclusion:Half adult dose rifampicin (300mg) is effective and safe in treatment of central serous chorioretinopathy without causing any systemic imbalance.

Effect of altering the regime of oral rifampicin therapy in the treatment of persistent central serous chorioretinopathy

“…Khan et al in their study of 38 eyes in 31 patients prescribed rifampicin 300mg for three months to patients primarily with recent onset CSCR and found that 74% of the patients improved in visual acuity and CMT and also no adverse effects were noted during the study 16. The results in the above study were higher because their 74.2% cases were acute CSCR which usually resolves in 80% of cases without any treatment17,18 but our study included only chronic CSCR and there is significant improvement even after change of regime of the drug.…”

Update on the Management of Central Serous Chorioretinopathy

“…Some studies have demonstrated efficacy in chronic CSCR; however, these are limited and non-placebo-controlled. 64,65 In contrast, a recent RCT demonstrated no benefit of rifampin for acute CSCR. 66 Any positive effect of rifampin must also be balanced against its known side effect profile that includes hepatotoxicity.…”

“…Rifampin is a potent inducer of cytochrome P450 enzymes which can modulate the metabolism of endogenous steroids and has been evaluated as a treatment for CSCR. Some studies have demonstrated efficacy in chronic CSCR; however, these are limited and non-placebo–controlled 64,65 . In contrast, a recent RCT demonstrated no benefit of rifampin for acute CSCR 66 .…”

Current Pharmacological Treatment Options for Central Serous Chorioretinopathy: A Review

“…In addition, Khan et al reported in an observational study on 38 eyes of 31 patients with CSC an improvement in mean BCVA from 0.56 to 0.47 ( p < 0.001) 4 weeks after 300 mg oral rifampicin treatment [ 66 ].…”