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Eleonora Beatriz Lavaque, Laura Gramajo, Juan Pablo Real, Claudio P Juarez, Ruth Estela Rosenstein, Jose D Luna Pinto; COMPARISON OF EPLERENONE VERSUS MELATONIN AS THERAPEUTIC OPTIONS FOR THE TREATMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5932. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
At present, there are no optimal therapies for chronic CSCR (central serous chorioretinopathy). Epleronone and melatonin are two of the many therapeutic option described for the treatment of disease. The aim of this study is to compare the efficacy of melatonin and eplerenone for the treatment of chronic CSCR.
Comparative, retrospective study. A total of 35 patients with chronic CSCR were treated: 20 patients were treated with 50 mg/day of oral eplerenone for 3 months, 10 patients were treated orally with 3 mg melatonin t.i.d for 1 month, and 5 patient were treated with placebo. All patients had 20/40 or worse Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) in the affected eye or presented an incapacitating scotoma. Most of the patients had previous failed treatments for their condition. Observational procedures included ETDRS BCVA, and complete ophthalmic examination. Optical Coherence Tomography (OCT) was performed at day 1 and week 4.
At one month follow up, CMT (central macular thickness) showed a significant decrease (P < 0.005) on both treatment groups, but change in macular thickness was significantly lower in the eplerenone group (P > 0.05 at 1 and 3 months). The mean decreased on CMT at 1 month was -43.9 µm and -146.5 µm for the eplerenone and melatonin groups respectively. These numbers were maintained at month 3.In terms of BCVA, both groups of treatment showed a mean significant improvement on visual acuity at one month, without significant differences between groups. No changes on BCVA or CMT were noted in the control group. No significant side effects were observed in any of the treatment groups.
Melatonin and eplerenone can be considered equally effective in improving BCVA on patients with chronic CSCR, although melatonin is statistically superior in promoting the reabsorption of SRF (subretinal fluid).
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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