September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Oral mineralocorticoid-receptor antagonists: real-life experience in clinical subtypes of non-resolving central serous chorioretinopathy with chronic epitheliopathy
Author Affiliations & Notes
  • Alexandre Matet
    Ophthalmology, Jules-Gonin Eye Hospital. University of Lausanne., Lausanne, Switzerland
  • Alejandra Daruich
    Ophthalmology, Jules-Gonin Eye Hospital. University of Lausanne., Lausanne, Switzerland
  • Ali Dirani
    Ophthalmology, Jules-Gonin Eye Hospital. University of Lausanne., Lausanne, Switzerland
  • Mathilde Gallice
    Ophthalmology, Jules-Gonin Eye Hospital. University of Lausanne., Lausanne, Switzerland
  • Luke Nicholson
    NIHR Moorfields Biomedical Research Centre, London, United Kingdom
  • Sobha Sivaprasad
    NIHR Moorfields Biomedical Research Centre, London, United Kingdom
  • Francine Behar-Cohen
    Ophthalmology, Jules-Gonin Eye Hospital. University of Lausanne., Lausanne, Switzerland
  • Footnotes
    Commercial Relationships   Alexandre Matet, None; Alejandra Daruich, None; Ali Dirani, None; Mathilde Gallice, None; Luke Nicholson, None; Sobha Sivaprasad, None; Francine Behar-Cohen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Alexandre Matet, Alejandra Daruich, Ali Dirani, Mathilde Gallice, Luke Nicholson, Sobha Sivaprasad, Francine Behar-Cohen; Oral mineralocorticoid-receptor antagonists: real-life experience in clinical subtypes of non-resolving central serous chorioretinopathy with chronic epitheliopathy. Invest. Ophthalmol. Vis. Sci. 201657(12):.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : The mineralocorticoid-receptor (MR) is involved in the pathogenesis of central serous chorioretinopathy (CSCR). Oral MR antagonists have demonstrated their efficacy in non-resolving acute CSCR, but little is known regarding their effect on long-standing cases with chronic epitheliopathy. This study aimed to evaluate the efficacy and safety of oral MR antagonists in 3 clinical presentations of non-resolving CSCR with chronic epitheliopathy.

Methods : Retrospective case series of consecutive patients with non-resolving CSCR and chronic epitheliopathy treated with oral eplerenone or spironolactone. Treatment criteria were: “persistent CSCR” with subretinal fluid (SRF) ≥4 months; “recurrent CSCR” with SRF ≥2 months; “persistent CSCR with tracks” defined as SRF ≥4 months with gravitational tracks on fundus autofluorescence. Outcomes at 1, 3 and 6 months were: foveal SRF height, central macular thickness (CMT), subfoveal choroidal thickness (SFCT), best-corrected visual acuity (BCVA) and occurrence of side effects.

Results : Among 54 eyes from 42 patients (mean age: 53 years; mean duration since CSCR diagnosis: 5.4 years), mean foveal SRF, CMT and SFCT decreased significantly at 1, 3 and 6 months after treatment initiation (6 months: p<0.0001, p=0.0003 and p<0.0001, respectively). Mean BCVA improved significantly at 6 months (p=0.041). In the persistent group, mean foveal SRF, CMT and SFCT decreased significantly at 3 and 6 months (6 months: p=0.006, p=0.017 and p=0.008, respectively). Similarly, in the recurrent group mean foveal SRF, CMT and SFCT decreased significantly at 3 and 6 months (6 months: p=0.012, p=0.026 and p=0.002, respectively). In persistent cases with tracks, a near-significant diminution of SRF and a significant diminution of mean CMT and SFCT were observed at 6 months only (p=0.058, p=0.044 and p=0.041, respectively). Overall, treatment-related side effects were observed in 6 patients, prompting discontinuation in 1 subject.

Conclusions : Response to oral MR antagonists was observed in the 3 presentations of CSCR and chronic epitheliopathy, with favorable tolerance. The SFCT decrease was consistent with the MR pathway implication in CSCR pathogenesis. In persistent CSCR with tracks the response was delayed, suggesting that longer treatment duration would be beneficial in chronic cases with severe RPE alteration.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×