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Marta Zola, Alejandra Daruich, Alexandre Matet, Francine F Behar-Cohen; Chronic central serous chorioretinopathy treated with mineralocorticoid-receptor antagonists: long-term follow up.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5931.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcomes of patients with chronic central serous chorioretinopathy (cCSCR) treated with mineralocorticoid-receptor (MR) antagonists after 24 months of follow-up.
Nineteen eyes of 17 patients with non-resolving cCSCR were treated with oral MR antagonists, either eplerenone or spironolactone. Best-corrected visual acuity (BCVA) and anatomical parameters including central macular thickness, subretinal fluid (SRF) height at the fovea, and sub-foveal choroidal thickness (SFCT) were measured during 24 months following initiation of treatment, and were compared with baseline values using the Wilcoxon test.
Thirteen patients (78%) were male and 4 (22%) were female. The mean age at presentation was 53±11 years. The mean duration of subretinal detachment affecting the fovea was 8.9±4.9 months before initiation of treatment. The mean duration of treatment was 22.1±8 months. Logarithm of the minimum angle of resolution (LogMAR) BCVA was 0.21 at baseline, 0.19 at 6 months (p=0.39), 0.15 at 12 months (p=0.086) and 0.17 at 24 months (p=0.25). The central macular thickness (CMT) was 320±67 µm at baseline, 270±36 µm at 6 months (p=0.0007), 276±47 µm (p=0.017) at 12 months and 259±42.8 µm at 24 months (p=0.0002). Foveal SRF was 95 ± 71 µm at baseline, 41±49 µm at 6 months (p=0.02), 51±58 µm at 12 months (p=0.052), and 25±35 µm at 24 months (p=0.004). Mean subfoveal choroidal thickness was 439±105 µm at baseline, 422±104 µm at 6 months (p=0.15), 376±91 µm at 12 months (p=0.019) and 392±99 µm at 24 months (p=0.046).
Oral MR antagonists had a favorable long-term anatomical effect in chronic, recalcitrant central serous chorioretinopathy. The decrease in choroidal thickness supported the involvement of the MR in CSCR pathogenesis. The treatment also led to a moderate visual improvement that remained non-significant due to the small study population. Results from prospective randomized studies are needed to confirm these encouraging observations.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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