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Robert Luda, Christiane Frank, Nikolaus Feucht, Chris Lohmann, Mathias Maier; Effects of Eplerenone as a Treatment Option for Patients with Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2583.
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Today there are still no guidelines with high level of evidence regarding the treatment of Chronic Central Serous Chorioretinopathy (CSC). According to the current state of studies available CSC is triggered by an overexpression of the Mineralocorticoid – pathway. Patients treated with an Aldosterone antagonist, such as Eplerenone, could benefit in their clinical outcome.The study’s aim is to assess the clinical effects of Eplerenone in the treatment of CSC and evaluate the outcome in a clinical setting.
48 eyes of 41 patients with symptomatic CSC were investigated, after receiving an oral treatment with Eplerenone 25 mg per day for the first week, followed by a 50 mg daily dose until the treatment’s end. SD-OCT was used for quantifying the changes in Subretinal Fluid (SRF) and Central Macula Thickness (CMT) before, during and after the intervention. Further, alterations in the Best-Corrected Visual Acuity (BCVA) were measured and examined.
A Total SRF resolution was observed in 12,5 % out of the inspected eyes and 20,8% showed a reduction >90% in SRF. 43,7% showed only a moderate decrease in SRF, whereas 56,3% didn’t show any change or rather even an increase in SRF. Relating to BCVA in 18 eyes an improvement from 0,32±0,28 LogMAR at baseline compared to 0,15±0,21 LogMAR after ending an oral Eplerenone therapy could be determined, linked to a detected substantial decline in CMT from 425±125 µm at baseline to 318±79 µm after treatment. 22 eyes did not show any difference in BCVA compared to baseline and in 8 cases the BCVA even deteriorated. The investigated group had a mean treatment period of 61±30 days. 3 patients had to terminate the treatment due to multiple side effects (e.g. high potassium)
This ongoing study shows benefits from an oral Eplerenone treatment in therapy responding patients suffering from CSC. Nevertheless, due to the variable cause of this disease further studies are needed to assess the value of Mineralocorticoid antagonists such as Eplerenone in the treatment strategy of CSC and to discuss different respond rates between sufferers.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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