Eplerenone Versus Observation in the Treatment of Acute Central Serous Chorioretinopathy: A Retrospective Controlled Study

• DOI: 10.1007/s40123-018-0121-2
• Publication Date: 2018-02-13T11:39:13Z
• Authors: Ilaria Zucchiatti; Riccardo Sacconi; Maria Cristina Pa...; Eliana Costanzo; Lea Querques; Daniela Montorio; Francesco Bandello; Giuseppe Querques
• Keywords: 0301 basic medicine; 03 medical and health sciences; 0302 clinical medicine; central serous chorioretinopathy; eplerenone; OCT angiography; optical coherence tomography; Central serous chorioretinopathy; Eplerenone; OCT angiography; Optical coherence tomography; Original Research; 3. Good health

To investigate the effects of eplerenone compared to observation in the treatment of acute central serous chorioretinopathy (CSC).Charts of consecutive patients with a diagnosis of acute CSC (visual symptoms < 12 weeks) were reviewed. Included patients were divided into a treatment group (treated with eplerenone) and a control group (observation). Main outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), height of subretinal fluid (SRF) and subfoveal choroidal thickness (CT) at 1 and 3 months in the two groups.Fifteen eyes of 15 patients (2 female, 13 male) and 12 eyes of 12 patients (1 female, 11 male [p = 1.000]) were included in the treatment and control groups, respectively. The mean age was 44 ± 9 (30-65) and 47 ± 11 years (28-66 years, p = 0.493), respectively. In the treatment group, BCVA improved significantly at 1 month (p = 0.018) and 3 months of follow-up (p = 0.011), while a non-significant improvement was seen in the control group. At 3 months, 12 of 15 eyes (80%) in the treatment group demonstrated complete SRF resolution, versus 3 of 12 eyes (25%) in the control group (p = 0.007). In the treatment group, SRF and CMT were significantly reduced at the 1-month follow-up (p = 0.014, p = 0.028, respectively) and the 3-month follow-up (p < 0.001 for both analyses), while in the control group the changes were not statistically significant. Eplerenone was well tolerated in all patients.Patients affected by acute CSC treated with eplerenone achieved greater and faster resolution of the disease compared to the observation group. Eplerenone may represent an attractive new first-line treatment option for acute CSC.