Comparison of eplerenone versus melatonin as therapeutic options for the treatment of non-resolving and chronic central serous chorioretinopathy

Abstract

Purpose : At present, there are no optimal therapies for chronic CSCR (central serous chorioretinopathy). Eplerenone and melatonin are two of the many therapeutic option described for this systemic disease. The aim of this study is to compare the efficacy of melatonin and eplerenone for CSCR treatment.

Methods : A comparative, retrospective study was developed with 36 patients with chronic CSCR. Twenty patients were treated with 50 mg/day of oral eplerenone for 3 months and 16 patients were treated orally with 3 mg melatonin three times a day for 1 month. Most of the patients had previous failed treatments for their condition. Observational procedures included ETDRS best-corrected visual acuity (BCVA), complete ophthalmic examination and Optical Coherence Tomography. Four time points were used: baseline, 1, 3 and 6 months.

Results : 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, 3 and 6 months). The mean decreased on CMT at 6 month was -44.9 µm and -218.2 µm for the eplerenone and melatonin groups respectively. In terms of BCVA, both treatment groups showed a mean significant improvement on visual acuity with a little differences in favor of melatonin treatment. No significant side effects were observed in any of the treatment groups.

Conclusions : Both eplerenone and melatonin are effective treatments for patients with CSCR, although there are small clinical differences in favor of melatonin when both treatments are compared.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Change in Best Corrected Visual Acuity (BCVA)

 

Change in Central Macular Thickness (CMT)