Oral mifepristone for chronic central serous chorioretinopathy

Chronic central serous chorioretinopathy (CCSC) can result in permanent loss of vision. Unfortunately, many cases of CCSC are not eligible or do not respond to treatment with thermal laser or photodynamic therapy. Glucocorticoids have been implicated in the pathogenesis of central serous chorioretinopathy. Mifepristone, an oral glucocorticoid receptor antagonist, may be helpful in cases of CCSC.

Mifepristone 200 mg was administered orally to 16 CCSC subjects in 2 separate protocols for up to 12 weeks. Visual acuity, examination, angiography, optical coherence tomography, and liver function were monitored during the treatment period.

Favorable response to oral mifepristone was seen in CCSC patients with seven subjects gaining five or more letters of vision and seven subjects having improved optical coherence tomography findings. Treatment was well tolerated without serious adverse effects.

Systemic glucocorticoid receptor antagonism with daily oral mifepristone does have a beneficial effect in treating some cases of CCSC. Further study is warranted.