SPIRONOLACTONE FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY: A RANDOMIZED CONTROLLED CROSSOVER STUDY.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Central serous chorioretinopathy (CSC) is characterized by persistent subretinal fluid (SRF).
• Nonresolving CSC poses challenges for visual acuity and requires effective therapeutic interventions.

Purpose of the Study:

• To investigate the efficacy of spironolactone, a mineralocorticoid receptor antagonist, in treating persistent central serous chorioretinopathy.
• To evaluate the impact of spironolactone on subretinal fluid and choroidal thickness in CSC patients.

Main Methods:

• Prospective, randomized, double-blinded, placebo-controlled crossover study design.
• 16 patients with CSC and SRF for ≥3 months received spironolactone (50 mg/day) or placebo for 30 days, followed by crossover.
• Primary outcome: change in SRF thickness; Secondary outcomes: subfoveal choroidal thickness and visual acuity.

Main Results:

• Spironolactone treatment led to a statistically significant reduction in SRF compared to placebo (P=0.04).
• A significant decrease in subfoveal choroidal thickness was observed with spironolactone versus placebo (P=0.02).
• No significant changes in best-corrected visual acuity or treatment-related complications were noted.

Conclusions:

• Spironolactone is effective in reducing both SRF and subfoveal choroidal thickness in eyes with persistent CSC.
• The findings support spironolactone as a potential therapeutic option for managing nonresolving central serous chorioretinopathy.