A Randomized Double-Blind Placebo-Control Pilot Study of Eplerenone for the Treatment of Central Serous Chorioretinopathy (Ecselsior)

Rahimy, Ehsan; Pitcher, John D.; Hsu, Jason; Adam, Murtaza K.; Shahlaee, Abtin; Samara, Wasim A.; Vander, J.F.; Kaiser, Richard; Chiang, Allen; Spirn, Marc J.; Fineman, Mitchell S.

doi:10.1097/iae.0000000000001649

Cited by 77 publications

(69 citation statements)

References 62 publications

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“…Test of proportion also showed that SRF height reduced significantly at different time interval as compared to at presentation (p<0.05). The better reduction was observed in Group A as compared to Group B. Rahimy E et al 13 in his study showed similar improvements in anatomical and functional status following eplerenone therapy. But there was no mention about contrast sensitivity in his study.…”

Section: Discussionmentioning

confidence: 60%

Efficacy of Drug Eplerenone in the Management of Chronic Central Serous Chorioretinopathy

Kumari¹,

Baidya²,

Khan³

2019

jebmh

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BACKGROUND Central serous chorioretinopathy (CSCR) is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy and branch retinal vein occlusion. Chronic Central Serous Chorioretinopathy is defined as persistence of sub-retinal fluid on Ocular Coherence Tomography beyond 3 months of onset of the disease. In the current study, we evaluated the efficacy of eplerenone in patients of chronic serous chorioretinopathy (CSCR). METHODS It is a randomized double blind study of sixty-eight eyes of sixty patients who were randomized into two groups. Thirty-five eyes of thirty patients in the treatment group (Group A), received 50 mg eplerenone daily for 3 months and thirty-three eyes of thirty patients in the control group (Group B) received one capsule of placebo drug (glucose powder) each day for the same duration. Visual acuity (VA), maximum height of sub-retinal fluid (SRF) and contrast sensitivity (CS) were studied at baseline and monthly thereafter for 6 months after initiation of therapy. RESULTS Better improvement of VA, reduction of SRF and improvement of CS were observed in the treatment group as compared to placebo. t-Test showed that there was significant difference in mean CS of the two groups at 6 months (p= 0.0459) and it also showed that there was significant difference in mean SRF of the two groups at the end of 6 months (p= 0.0491). CONCLUSIONS Eplerenone could be beneficial as an alternate mode of therapy in the treatment of chronic CSCR.

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Section: Discussionmentioning

confidence: 60%

Efficacy of Drug Eplerenone in the Management of Chronic Central Serous Chorioretinopathy

Kumari¹,

Baidya²,

Khan³

2019

jebmh

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“…[34].Most of the studies of that subject show moderate BCVA improvement , usually by less or about 0,1logMAR. [35,36,37] Laser photocoagulation is of limited use in chronic CSCR as it requires the leakage point to be located outside the fovea. In CCSCR usually we approach a variety and multiplicity of symptoms that include subretinal fluid, pigment epithelial detachment and alterations of the retinal pigment epithelium, often without well demarcated leakage points.…”

Section: Discussionmentioning

confidence: 99%

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Gawęcki¹,

Jaszczuk-Maciejewska²,

Jurska-Jaśko³

et al. 2019

Preprint

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Purpose Central serous chorioretinopathy(CSCR) is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy and refer it to healthy individuals. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods The study group consisted of thirty-two eyes (13 female and 19 male, mean age 49.6 years SD +/- 10.5) with chronic central serous chorioretinopathy ( mean duration 18.9 months SD +/- 15.4) in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment. Inclusion criterion was a lack of subretinal fluid within the whole area of the central retina scanned by the spectral domain optical coherence tomography. The group was extracted out of 51 cases of chronic CSCR that were treated with that method. They were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group, which consisted of 40 eyes of healthy individuals with full distance visual acuity (0.0 logMAR, 1.0 Snellen) never treated with subthreshold micropulse laser. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choriocapillaries flow signal even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. Further research is needed to determine precisely the timepoint of this damage.

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“…In all, 33% of eplerenonetreated eyes (5/15) and 17% (1/6) of placebo-treated eyes showed complete SRF absorption after 2 months of therapy. Eplerenone-treated patients also achieved a slight and statistically significant improvement in visual acuity at 2 months after therapy, whereas patients in the control group experienced a slight deterioration [65]. In their randomized controlled trial, Schwartz et al also found a significant reduction of SRF in the eplerenone group at 1, 3, and 5 months following treatment initiation compared with baseline findings.…”

Section: Mineralocorticoid Receptor Antagonistsmentioning

confidence: 92%

“…A number of randomized placebocontrolled studies published recently investigated the effect of spironolactone and eplerenone on SRF and visual acuity in CSC patients with SRF that failed to absorb within 3-4 months [6,60,65,72]. Bousquet et al report that 1 month of spironolactone therapy achieves a reduction in SRF and subfoveal choroidal thickness (p = 0.04), but does not change visual acuity compared with placebo controls [6].…”

Section: Mineralocorticoid Receptor Antagonistsmentioning

confidence: 99%

Statement of the Professional Association of German Ophthalmologists (BVA), the German Society of Ophthalmology (DOG) and the German Retina Society (RG) on central serous chorioretinopathy

2018

Ophthalmologe

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A Randomized Double-Blind Placebo-Control Pilot Study of Eplerenone for the Treatment of Central Serous Chorioretinopathy (Ecselsior)

Abstract: These findings suggest that oral eplerenone therapy is safe and potentially effective in the treatment of chronic central serous chorioretinopathy with persistent subretinal fluid.

Cited by 77 publications

References 62 publications

Efficacy of Drug Eplerenone in the Management of Chronic Central Serous Chorioretinopathy

Efficacy of Drug Eplerenone in the Management of Chronic Central Serous Chorioretinopathy

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Statement of the Professional Association of German Ophthalmologists (BVA), the German Society of Ophthalmology (DOG) and the German Retina Society (RG) on central serous chorioretinopathy

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