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MINERALOCORTICOID RECEPTOR ANTAGONIST TREATMENT IN BILATERAL CHRONIC CENTRAL SEROUS CHORIORETINOPATHY: A COMPARATIVE STUDY OF EXUDATIVE AND NONEXUDATIVE FELLOW EYES

Gergely, Róbert MD; Kovács, Illés MD, PhD; Schneider, Miklós MD, PhD; Resch, Miklós MD, PhD; Papp, András MD, PhD; Récsán, Zsuzsanna MD, PhD; Nagy, Zoltán Zsolt MD, PhD, DSc; Ecsedy, Mónika MD, PhD

doi: 10.1097/IAE.0000000000001303
Original Study

Purpose: To evaluate the macular thickness, choroidal thickness, and visual acuity changes in eyes of patients with bilateral chronic central serous chorioretinopathy during eplerenone treatment.

Methods: This prospective clinical trial was conducted on patients with bilateral chronic central serous chorioretinopathy, who had subretinal fluid (SRF) in 1 eye. Twenty-eight patients were treated with 50 mg/day of oral eplerenone for 3 months and were observed for another 3 months. Twenty-eight eyes with SRF were compared with the 28 fellow eyes with pachychoroid pigment epitheliopathy.

Results: The central macular and choroidal thickness showed a significant decrease (P < 0.005) at 3 months in all eyes, but change in choroidal thickness was smaller in nonexudative fellow eyes (P > 0.05 at 6 months). In the exudative eyes, the decrease in choroidal thickness showed a significant correlation with the resolution of SRF (P < 0.001). Visual acuity remained stable in all eyes, with significant improvement only in exudative eyes at 6 months (P < 0.005). Baseline choroidal thickness was a significant positive predictor for SRF decrease (P = 0.003).

Conclusion: Patients with chronic central serous chorioretinopathy can safely be treated with eplerenone as it can reverse choroidal vasodilation with an accompanying resolution of the SRF and improvement in visual acuity. These beneficial therapeutic effects are more pronounced in the exudative eyes.

The authors compared the treatment response to eplerenone in exudative and nonexudative eyes of patients with bilateral chronic central serous chorioretinopathy. Eplerenone reversed the choroidal vasodilation in all eyes, with resolution of the subretinal fluid in the exudative eyes. Treatment was more effective in eyes with subretinal fluid and with thicker choroid at baseline.

Ophthalmology Department, Semmelweis University Budapest, Hungary.

Reprint requests: Róbert Gergely, MD, Ophthalmology Department, Semmelweis University Budapest, Mária 39, Budapest 1085, Hungary; e-mail: gergelyrobert.dr@gmail.com

None of the authors have any financial/conflicting interests to disclose.

© 2017 by Ophthalmic Communications Society, Inc.