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Br J Ophthalmol. 2019 May 11. pii: bjophthalmol-2019-314047. doi: 10.1136/bjophthalmol-2019-314047. [Epub ahead of print]

Eplerenone for the treatment of chronic central serous chorioretinopathy: 3-year clinical experience.

Author information

1
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
2
Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, USA.
3
Department of Retina and Uveitis, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, USA.
4
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA drrishisingh@gmail.com.

Abstract

BACKGROUND/AIMS:

The efficacy of mineralocorticoid receptor antagonist eplerenone to treat chronic central serous chorioretinopathy (CSCR) has been established. However, previous studies have been limited by small cohort size and short follow-up duration. This study aims to report 3-year clinical outcomes of patients treated with eplerenone for chronic CSCR.

METHODS:

Institutional review board-approved retrospective chart analysis at a single institution from 2012 to 2018. Baseline best-corrected visual acuity and anatomical measurements related to degree of subretinal fluid (SRF) were collected at eplerenone initiation. Follow-up data were collected at the closest date to 12, 24 and 36 months.

RESULTS:

Data were obtained for 100 eyes of 83 patients at 1-year (mean 11.18 ± 4.00 months), 49 eyes at 2-year (24.01 ± 3.33 months) and 33 eyes at 3-year (mean 35.5 ± 7.89 months) follow-up visits. The rate of complete SRF resolution was 31%, 28% and 33%, respectively. At final follow-up, logarithm of the minimum angle of resolution visual acuity change from baseline was +0.10 ± 0.24 (p = 0.130). Average change from baseline at final follow-up for central subfield thickness was -97 ± 140.6 µm (p < 0.001), cube volume was -1.07 ± 1.71 mm3 (p < 0.001), macular thickness -28. 5 ± 47.5 µm (p < 0.001), maximum SRF height was -95.6 ± 160.5 µm (p < 0.001) and maximum SRF diameter was -1169.0 ± 1638.7 µm (p = 0.008).

CONCLUSION:

Anatomical improvement occurs primarily within the first year of eplerenone treatment for chronic CSCR.

KEYWORDS:

Eplerenone; Macular edema; central serous chorioretinopathy; retina

Conflict of interest statement

Competing interests: DP, DG, FC and GH: None to Declare. AB reports grants from Regeneron, personal fees from VINDICO, MCME Global, outside the submitted work; AR reports personal fees from Allergan, Alcon, Zeiss, outside the submitted work; AS reports personal fees and other from American Academy of Ophthalmology, outside the submitted work; In addition, AS has a patent Elsevier with royalties paid and may receive possible future payments (none to-date) from Easton Capital. JE reports personal fees from Bioptigen, Leica, Zeiss, Alcon, Santen, grants and personal fees from Thrombogenics, Genentech, grants from Regeneron, outside the submitted work; JE has a patent Bioptigen issued. PK personal fees from Bausch and Lomb, Novartis, Carl Zeiss Meditec, Topcon, Allergan, outside the submitted work. RS reports grants and personal fees from Genentech/Roche, Alcon/Novartis, grants from Apellis, personal fees from Optos, Zeiss, from Biogen, grants and personal fees from Regeneron Pharmaceuticals, Inc., outside the submitted work; SKS reports grants and personal fees from Bausch and Lomb, Leica, Santen, grants and personal fees from Carl Zeiss Meditec, grants from Allergan, outside the submitted work; SKS has a patent Bioptigen and Synergetics issued. SS reports personal fees from Allergan, outside the submitted work.

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