Abstract
Purpose :
Central serous chorioretinopathy (CSCR) is a disease of multifactorial etiology that is often observed until resolution. The purpose of this study is to compare the efficacy of mineral receptor antagonists eplerenone and spironolactone in the treatment of chronic CSCR. We hypothesize that both medications have a similar efficacy.
Methods :
An IRB-approved retrospective review was conducted on patients that were diagnosed with chronic CSCR, which is defined as persistence of subretinal fluid for more than 3 months. Patients were divided into eplerenone (25mg daily) and spironolactone (50mg twice per day) treatment groups. The primary outcomes included change in visual acuity and central macular thickness (CMT) before and after therapy. Statistical significance was determined using analysis of variance (ANOVA). Secondary outcomes included any reported adverse events while taking these oral mineral receptor antagonists.
Results :
Clinical charts from 15 eyes with chronic CSCR were reviewed, of which 7 eyes were treated with eplerenone and 8 eyes were treated with spironolactone. Optical coherence tomography (OCT) was obtained upon the initiation of the respective medication and again at the 6-12 week follow up period. There was no statistically significant difference between the initial CMT of both treatment groups. At the follow up visit, CMT reductions in the eplerenone and spironolactone groups were 66.9 µm and 99.8 µm, respectively (P=0.56). Likewise, there was no statistically significant difference (P=0.6) in ETDRS letter gain between eplerenone and spironolactone, at 1.9 letters and 3.5 letters respectively. No systemic adverse events were noted in the 6-12 week treatment period. The average 30 day supply cost1 of eplerenone 25 mg daily is $124.97, while spironolactone 50 mg twice per day is $57.40.
1. GoodRx.com
Conclusions :
Eplerenone and spironolactone have a similar efficacy in the treatment of chronic CSCR. The cost of spironolactone is approximaetly half the cost of eplerenone. In a small sample size, we have no reportable side effects or safety concerns.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.