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Jin Young Kim, Joong Hyun Park, Dong Yoon Kim; Spironolactone in the treatment of central serous chorioretinopathy : long-term results and recurrence rates. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1838. doi: https://doi.org/.
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Spironolactone in the treatment of central serous chorioretinopathy : long-term results and recurrence rates
Non-resolving CSC and a follow-up period at least 6 months from the initial spironolactone (50mg, once a day) for treatment-naïve CSC were retrospectively evaluated from 2 institutions in Korea. Best corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid height (SRFH) were compared longitudinally. They were divided into successful (5 eyes) and unsuccessful (19 eyes) groups based on SRF absorption and disease recurrence after spironolactone. Age, gender, BCVA, CMT, SRFH were compared between the groups. Factors associated with spironolactone at 12 months were investigated. The recurrence rate was examined.
Twenty-four eyes of 24 patients were recruited, males (19 patients, 79.1%), females (5 patients, 20.8%). The mean age 48.08±7.99 years of age (34-62). Spironolactone demonstrated statistically significant visual acuity improvement (0.13 ± 0.20), CMT reduction (225.09 ± 63.16 µm) and SRFH reduction (63.71 ± 74.06 µm) at 12 months compared to baseline (0.38 ± 0.21, P=0.007 ; 373.54 ± 96.96 µm, P=0.007 ; 211.45 ± 92.85 µm, P<0.001, respectively) (figure 1). Of the 24 study eyes treated, 62.5%(n=15) showed complete regression on OCT, But, ten of the 15 (66.7%) patients presented ≥ 1 recurrences during a mean follow-up of 10.00±2.82 months (range, 6-16 months). Successful group had a better results at 12 months (figure 2). Of the recurrent eyes, the mean number of recurrence was 1.2. There was no recurrence after total resolution in 5 eyes (20.8%). Total recurrence rate using kaplan-meier survival analysis was 68% (cumulative survival rate : 0.3200). There were no complications related to treatment observed.
Spironolactone had a positive effect in the reduction of SRF and recovery of visual acuity. But, large numbers in the spironolactone had a high recurrent rate.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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