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Oussama Boundaoui, Andrew Chon, Michael Davis; Eplerenone in the treatment of active central serous chorioretinopathy.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1111.
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© 2017 Association for Research in Vision and Ophthalmology.
Central serous chorioretinopathy (CSCR) is an idiopathic condition featuring serous detachments of the neuosensory retina and/or retinal pigment epithelium (RPE) caused by avascular fluid exudation through the RPE. We evaluated the efficacy of systemic eplerenone, a mineralocorticoid receptor anatagonist, in the treatment of CSCR by examining its effect on central foveal thickness and visual acuity.
Retrospective case series of 11 patients (9 male, 2 female) with active central serous chorioretinopathy. All patients underwent a fundoscopic examination and spectral-domain optical coherence tomography. Exclusion criteria included concurrent therapy for CSCR with topical, focal laser, or systemic therapy. All patients received either 25mg, 50mg, or 100mg of eplerenone daily for at least 1 month. Follow-up ranged from 2 months to 8 months. Nine of eleven patients had chronic CSCR with duration of disease ranging from 4 months to 2 years (mean 9 months). Two of eleven patients had new-onset CSCR, and were treated within 1 month of symptoms due to occupation visual requirements. A two-tailed unpaired t-test was used to compute the statistical significance of pre-treatment and post-treatment variables.
7 of 11 (63%) patients achieved decrease in central foveal thickness (CFT) after treatment with eplerenone. 3 of 11 patients (27%) achieved complete resolution of subretinal fluid. CFT before eplerenone ranged from 235 to 715 microns (mean 472.18 microns), and after treatment ranged from 128 to 580 microns (mean 329.73 microns). The decrease in CFT after treatment was statistically significant (p=0.034). No statistically significant improvement in visual acuity was found (p=0.8734)
Eplerenone shows efficacy in the treatment of CSCR by reducing the central foveal thickness. Visual acuity, however, did not improve. A large prospective randomized trial is needed to further investigate the role of eplerenone in the treatment of CSCR.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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