Purpose: To evaluate the efficacy of eplerenone, a mineralocorticoid receptor antagonist, in the treatment of chronic central serous chorioretinopathy (CSCR).
Materials and methods: We conducted a retrospective study of 27 patients treated with eplerenone for chronic CSCR of at least 3 months duration. For each patient, visual acuity and macular OCT (central retinal thickness, height of foveal subretinal fluid (SRF), central choroidal thickness) were evaluated before treatment and at 1 month and 3 months. In the case of complete disappearance of SRF at 1 month, treatment was discontinued and follow-up was performed at 3 months.
Results: Central retinal thickness was 371.6μm (266-573μm) before treatment. A clear decrease in retinal central thickness and height of SRF was observed at 1 month in 74% of patients (20 of 27 patients, central retinal thickness: 322.6μm at 1 month, P=0.01), with improvement of visual acuity in all of these patients. Follow-up at 3 months also found a decrease in SRF and central retinal thickness (294.3μm, P=0.002). Six patients had complete resolution of SRF at 1 month, without recurrence at 3 months. Six other patients had complete resolution of SRF at 3 months. No side effects requiring treatment discontinuation were observed.
Conclusion: In our study, eplerenone was associated with regression of central retinal thickness and height of SRF. Eplerenone appears to be a safe and effective treatment for chronic CSCR, with a probable mechanism of action on the pathophysiology of this disease.
Keywords: Central serous chorioretinopathy; Choriorétinite séreuse centrale chronique; Eplerenone; Liquide sous-rétinien; Mineralocorticoid receptors; Récepteurs aux minéralocorticoïdes; Subretinal fluid; Traitement; Treatment; Éplérénone.
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