Functionality of retinal vessels in central serous retinopathy: A comparison between eplerenone and photodynamic therapy

Eur J Ophthalmol. 2023 May;33(3):1443-1451. doi: 10.1177/11206721221145049. Epub 2022 Dec 12.

Abstract

Purpose: To investigate retinal vessels functionality in patients with acute central serous chorioretinopathy (CSC) undergoing oral eplerenone or photodynamic therapy (PDT) using Retinal Vessel Analyzer (RVA) and Dynamic Vessel Analyzer (DVA), respectively.

Methods: Treatment naïve acute CSC patients presenting between May 2017 and June 2017 were recruited. A complete ophthalmological examination was performed in all participants before and after oral eplerenone (eplerenone group) or half-dose PDT (PDT group).

Results: Eighteen eyes of 18 patients affected by acute CSC underwent either oral eplerenone (10 eyes of 10 patients, 47.6 ± 8.9 years old) or half-dose PDT (8 eyes of 8 patients, 57.4 ± 6.2 years old), respectively. After 2 months of treatment, non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were reported in eplerenone group. Similarly, in PDT group non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were found after 2 months of treatment.

Conclusions: Static and dynamic retinal functionalities in acute CSC may not be significantly improved by oral eplerenone and half-dose PDT. Although their choroidal effects, these treatments could not exert a significant effect on retinal vessels motility. Thus, both local and systemic therapies might not help avoiding the onset of vascular and other retinal known alterations of CSC.

Keywords: OCT.; Retinal vessel analyzer; central serous chorioretinopathy; dynamic vessel analyzer; eplerenone; flicker light; photodynamic therapy; retinal vessel analysis.

MeSH terms

  • Adult
  • Central Serous Chorioretinopathy* / diagnosis
  • Central Serous Chorioretinopathy* / drug therapy
  • Chronic Disease
  • Eplerenone / therapeutic use
  • Fluorescein Angiography
  • Humans
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins* / therapeutic use
  • Retinal Vessels
  • Tomography, Optical Coherence

Substances

  • Eplerenone
  • Photosensitizing Agents
  • Porphyrins