Eplerenone for chronic central serous chorioretinopathy-a randomized controlled prospective study

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Central serous chorioretinopathy (CSC) is a condition characterized by fluid accumulation under the retina.
• Chronic nonresolving CSC presents a therapeutic challenge.
• Eplerenone, a mineralocorticoid receptor antagonist, has been investigated for its potential in treating CSC.

Purpose of the Study:

• To assess the efficacy and safety of eplerenone in patients with chronic nonresolving CSC.
• To compare eplerenone treatment against a placebo in managing persistent subretinal fluid (SRF).

Main Methods:

• A prospective, double-blind, randomized placebo-controlled trial was conducted.
• 17 patients with persistent SRF due to CSC were randomized to receive either eplerenone (50 mg/day) or placebo for 3 months.
• Outcomes measured included changes in SRF, choroidal thickness, and best-corrected visual acuity (BCVA).

Main Results:

• Both eplerenone and placebo groups showed SRF reduction; however, significant reduction occurred only in the eplerenone group at specific time points.
• Complete SRF resolution rates were similar: 23% for eplerenone and 30.8% for placebo.
• No significant difference in choroidal thickness was observed. The placebo group showed a significant BCVA improvement at 4 months, with a significant difference favoring placebo at 3 months.

Conclusions:

• Eplerenone was not found to be superior to placebo for treating chronic CSC.
• The study did not demonstrate a significant benefit of eplerenone over placebo in resolving SRF or improving visual acuity in this patient population.
• No adverse events were associated with eplerenone use.