Eplerenone for the treatment of chronic central serous chorioretinopathy: 3-year clinical experience

Br J Ophthalmol. 2020 Feb;104(2):182-187. doi: 10.1136/bjophthalmol-2019-314047. Epub 2019 May 11.

Abstract

Background/aims: The efficacy of mineralocorticoid receptor antagonist eplerenone to treat chronic central serous chorioretinopathy (CSCR) has been established. However, previous studies have been limited by small cohort size and short follow-up duration. This study aims to report 3-year clinical outcomes of patients treated with eplerenone for chronic CSCR.

Methods: Institutional review board-approved retrospective chart analysis at a single institution from 2012 to 2018. Baseline best-corrected visual acuity and anatomical measurements related to degree of subretinal fluid (SRF) were collected at eplerenone initiation. Follow-up data were collected at the closest date to 12, 24 and 36 months.

Results: Data were obtained for 100 eyes of 83 patients at 1-year (mean 11.18 ± 4.00 months), 49 eyes at 2-year (24.01 ± 3.33 months) and 33 eyes at 3-year (mean 35.5 ± 7.89 months) follow-up visits. The rate of complete SRF resolution was 31%, 28% and 33%, respectively. At final follow-up, logarithm of the minimum angle of resolution visual acuity change from baseline was +0.10 ± 0.24 (p = 0.130). Average change from baseline at final follow-up for central subfield thickness was -97 ± 140.6 µm (p < 0.001), cube volume was -1.07 ± 1.71 mm3 (p < 0.001), macular thickness -28. 5 ± 47.5 µm (p < 0.001), maximum SRF height was -95.6 ± 160.5 µm (p < 0.001) and maximum SRF diameter was -1169.0 ± 1638.7 µm (p = 0.008).

Conclusion: Anatomical improvement occurs primarily within the first year of eplerenone treatment for chronic CSCR.

Keywords: Eplerenone; Macular edema; central serous chorioretinopathy; retina.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Central Serous Chorioretinopathy / drug therapy*
  • Central Serous Chorioretinopathy / physiopathology
  • Chronic Disease
  • Eplerenone / therapeutic use*
  • Female
  • Humans
  • Macula Lutea / pathology
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Retrospective Studies
  • Visual Acuity / physiology

Substances

  • Mineralocorticoid Receptor Antagonists
  • Eplerenone