evaluation of therapeutic effect of rifampin for acute central serous chorioretinopathy

purpose: to evaluate the beneficial effects of rifampin for the treatment of central serous chorioretinopathy (cscr). methods: in this non-randomized clinical trial, 39 patients with acute cscr (<2 weeks) were enrolled. initially, complete visual examinations including determination of best spectacle-corrected visual acuity (bscva) using snellen chart; anterior and posterior segment examination was performed. fundus fluorescein angiography (ffa) and ocular coherence tomography (oct) were also performed to confirm the diagnosis. twenty-three patients were treated with 600 mg rifampin per day for a maximum of 4-6 weeks (treatment group) and 17 patients did not receive any treatment (control group). the patients were examined post treatment at weeks 2, 4 & 6. at each follow-up examination bcva and fundoscopy were performed. if no macular edema was observed in fundoscopy, oct was performed; otherwise oct was performed at the end of 4th-6th week. primary objective was reduction in macular thickness (mt) and secondary objective was the bscva. results: mean age of patients was 38.5±6.7 years; 37.7±6.2 years in the treatment group and 39.7±7.3 years in the control group (p>0.05). 76.9% of patients were male. mean mt reduced from 339.9±44.36 µm at the beginning of treatment to 297.4±29.09 µm at the final visit (12.58% reduction, p<0.001). in the control group, the figures were 310.06±20.31 and 296.71±17.22 µm, respectively (4.3% reduction, (p<0.003). the treatment group demonstrated more reduction in mt (p<0.018). mean bscva was 0.2±0.18 and 0.6±0.34 sv before and after treatment respectively (p<0.0001) in the treatment group and 0.2±0.1 and 0.37±0.35 sv, respectively (p<0.024) in the control group. the difference in bscva between the two groups was significant (p=0.055). macula was dry in 45.5% of the treatment group and 29.4% of the control group at the end of study (or=2 ci95%, 0.52-7.6, p=0.307). all the patients with dry macula at the end of study in the treatment group were followed for 9 months and no recurrence of the lesion was found. conclusion: rifampin has beneficial effects in the treatment of acute cscr. these early findings suggest a novel treatment of cscr and warranted further study.