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Min Zhao, Elodie Bousquet, Francine Behar-Cohen; Mineralocorticoid Receptor Antagonism in the Treatment of Chronic Central Serous Chorioretinopathy: First Pilot Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2813.
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Based on experimental data showing that central serous chorioretinopathy (CSC) could result from over-activation of mineralocorticoid receptor (MR) pathway in choroid vessels, we studied a MR antagonist, eplerenone, as a potential treatment for chronic CSC.
Thirteen patients with chronic CSC were included in a pilot prospective study. Patients were treated with oral eplerenone 25 mg/day for a week followed by 50 mg/day for 1 or 3 months. The primary outcome measure was the change in central macular thickness (CMT) recorded by optical coherence tomography (OCT) at 1 and 3 months after eplerenone treatment. The secondary outcomes included changes in foveal subretinal fluid (SRF) measured by OCT and in best-corrected visual acuity (BVCA) at 1 and 3 months after eplerenone treatment.
CMT decreased significantly from 352±139 μm at baseline, to 246±113 μm and 189±99 μm at 1 and 3 months under eplerenone treatment (p<0.05 and p<0.01, respectively). The SRF level at 3 months was significantly decreased compared with baseline SRF (p<0.01). BVCA at 3 months was significantly improved compared with baseline BVCA (p<0.001). The treatment was well tolerated.
Eplerenone treatment was associated with a significant reduction in central macular thickness, subretinal fluid level and an improvement in visual acuity. Randomized controlled trials are needed to confirm these encouraging results.
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