Oral eplerenone for treatment of chronic central serous chorioretinopathy: a case series

Ophthalmic Surg Lasers Imaging Retina. 2015 Apr;46(4):439-44. doi: 10.3928/23258160-20150422-06.

Abstract

Background and objective: To evaluate the effect of oral eplerenone on subretinal fluid, visual acuity, and choroidal thickness in patients with chronic central serous chorioretinopathy (CSCR).

Patients and methods: Retrospective review of all patients (14 eyes of 14 patients) monitored for a minimum of 3 months with chronic CSCR who were treated with oral eplerenone in a single multi-physician retina practice. Visual acuity, dilated funduscopic examination, and spectral-domain ocular coherence tomography (OCT) with enhanced depth imaging (EDI) were obtained at each visit. Measurement of subfoveal fluid (SFF) height and choroidal thickness were performed. Two-tailed paired t test was used to calculate statistical significance of pre- and post-treatment variables.

Results: At 1 month, 10 of 14 eyes had decreased SFF height on OCT and two eyes had complete resolution of SFF. Mean SFF height decreased from 130 µm to 62 µm (P = .05). Mean choroidal thickness decreased from 315 µm to 282 µm (P = .07). Mean visual acuity improved from logMAR 0.41 to 0.40. At 3 months, 13 of 14 (93%) had decreased SFF on OCT, and nine eyes (64%) had complete resolution of SFF. Mean SFF height decreased to 21 µm (P = .004). Mean choroidal thickness decreased to 253 µm (P = .10). Mean visual acuity improved to logMAR 0.28 (P = .02).

Conclusion: Oral eplerenone may be effective in treating patients with chronic CSCR.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / drug therapy*
  • Central Serous Chorioretinopathy / physiopathology
  • Choroid / pathology
  • Chronic Disease
  • Eplerenone
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / adverse effects
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Retrospective Studies
  • Spironolactone / adverse effects
  • Spironolactone / analogs & derivatives*
  • Spironolactone / therapeutic use
  • Subretinal Fluid / drug effects
  • Tomography, Optical Coherence
  • Visual Acuity / drug effects

Substances

  • Mineralocorticoid Receptor Antagonists
  • Spironolactone
  • Eplerenone