Eplerenone repurposing in management of chorioretinopathy: Mechanism, nanomedicine-based delivery applications and future trends

Br J Clin Pharmacol. 2022 Jun;88(6):2665-2672. doi: 10.1111/bcp.15213. Epub 2022 Feb 3.

Abstract

Chronic central serous chorioretinopathy (CSCR) is an ocular threatening disease, a common cause of central vision loss, affecting the posterior pole of the eye. Eplerenone (EPL) is a selective mineralocorticoid receptor antagonist that is primarily used to treat hypertension. Recently, it has shown many benefits in modifying the physio-pathological processes occurring upon stimulation of renin-angiotensin-aldosterone system at the ocular level. In CSCR treatment, several clinical studies and case reports prove the efficacy and safety of EPL. However, setbacks for such studies include a relatively small number of participants and short follow-up periods. This review article is intended to describe theories about the nature and classification of CSCR and recapitulate EPL therapeutic benefits as selective mineralocorticoid receptor antagonist in the treatment of CSCR. Furthermore, we survey the literature on clinical studies discussing the results of use of EPL in treatment of CSCR. In addition, EPL therapeutic formulations that have been developed are described, and future potential delivery systems will be suggested.

Keywords: chronic central serous retinopathy; eplerenone; selective mineralocorticoid antagonist.

Publication types

  • Review

MeSH terms

  • Central Serous Chorioretinopathy* / drug therapy
  • Chronic Disease
  • Eplerenone
  • Humans
  • Mineralocorticoid Receptor Antagonists* / therapeutic use
  • Nanomedicine
  • Spironolactone / therapeutic use

Substances

  • Mineralocorticoid Receptor Antagonists
  • Spironolactone
  • Eplerenone