[Incidence of retinal vein occlusion during the football World Cup in 2014 : A database analysis]. / Inzidenz von Zentralvenen- und Venenastverschlüssen während der Fußballweltmeisterschaft 2014 : Eine Datenbankanalyse.

BACKGROUND: The association between cardiovascular events, such as acute coronary syndrome and emotional triggers, such as football world cups is well-known. Significant differences could sometimes be identified depending on the country of origin and design of the study. From an ophthalmological perspective the correlation between pre-existing cardiovascular diseases and retinal angiopathy is well-known. This study investigated whether the incidence of retinal vein occlusion (RVO) at a German university eye clinic increased during and 4 weeks after the 2014 football World Cup. METHODS: From the electronic files of almost 290,000 patients contained in the Smart Eye database, those with RVO during and 4 weeks after the 2014 football World Cup (from 12 June to 13 August 2014) and during the same time period in 2013 could be identified. Demographic data, visual acuity, intraocular pressure (IOP) and laboratory parameters were extracted and compared, when available. RESULTS: From 10 male (average age 68 years) and 8 female (average age 62 years) a total of 9 central RVO (CRVO), 8 branch RVO (BRVO) and 1 hemi-CRVO were identified in 2013 with a visual acuity ranging from 0.05 to 0.9 (average 0.39) and an IOP from 12 mmHg to 25 mmHg (average 16 mmHg). In 2014 a total of 26 patients (11 male average age 67 years and 15 female average age 76 years) were identified, an increase of 69 % (15 CRVO, 6 BRVO and 5 hemi-CRVO). The visual acuity ranged from 0.05 to 1.0 (average 0.63) and the IOP from 8 mmHg to 24 mmHg (average 15 mmHg). CONCLUSION: Due to the high comparability of the patient collectives an increase of RVO during and 4 weeks after the 2014 football World Cup could be identified, compared to the same period in 2013. It can be assumed that emotional strain caused by a World Cup is a risk factor. Data from other centers have to be assessed in order to be able to make a more general statement.

Spironolactone in the treatment of central serous chorioretinopathy - a case series.

BACKGROUND: The pathogenesis of central serous chorioretinopathy (CSC) is still poorly understood. An animal model of CSC proved that the mineralocorticoid receptor [1] of the choroid also plays a role in CSC. Since there is still no evidence-based therapy for non-self-limiting CSC, this case series evaluates the effect of oral spironolactone in CSC patients. METHODS: In this interventional, uncontrolled, prospective case series, we present 18 consecutive CSC patients. Patients were treated with spironolactone 25 mg twice daily (Spironolacton AL® 50 mg, ALIUD PHARMA) for up to 12 weeks. Follow-up examinations with BCVA, OCT, and EDI-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. RESULTS: The subretinal fluid (SRF; mean) decreased from 219 µm (baseline) to 100 µm (visit 3) (difference 119 µm). Total central retinal thickness (CRT; mean) decreased from 405 µm before treatment (baseline) to 287 µm after treatment (difference 118 µm). The BCVA (in logMAR; mean) increased from 0.32 at baseline to 0.20 at visit 3. CONCLUSION: Our case series 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.