Effect of oral eplerenone in anatomical and functional improvement in patients with chronic central serous chorioretinopathy.

Asad Habib,Masood Alam Shah,Omer Farooq,Najia Ahmed

doi:10.12669/pjms.35.6.896

Asad Habib, Masood Alam Shah + Show 2 more

Open Access

https://doi.org/10.12669/pjms.35.6.896

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Abstract

Objective:To determine the efficacy of oral eplerenone in anatomical and functional improvement in patients with chronic central serous chorioretinopathy (CSCR).Methods:This quasi experimental study was performed at PNS Shifa Hospital Karachi from September 2018 to February 2019. Study included 23 patients. Patients were included using consecutive sampling technique and informed consent was taken from all patients before staring treatment. 50 mg of oral eplerenone per day was given for three months. Subretinal fluid (SRF) height and visual acuity (VA) were noted at baseline, one month and three month follow-up. Structured Study performa was used for data collection. Data was analysed and assessed with SPSS version 23. P value of <0.05 was considered statistically significant.Results:Mean age of patients was 40.7±7 years and mean duration of disease before treatment was 3.7±0.76 months. Mean baseline BCVA and SRF height was 0.39±0.02 logMAR and 123±12.5 µm respectively. Sixty-five percent patients responded at one month and 80% at three months with reduction in SRF height. Improvement in visual acuity was also statistically significant at 3 months (p<0.05).Conclusion:Use of eplerenone in chronic CSCR resulted in significant improvement in vision and decrease in mean SRF height.

Highlights

central serous chorioretinopathy (CSCR) is a sight threatening condition associated with serous exudation between pigmentary and neurosensory retinal causing a localized retinal detachment.1CSCR is considered 4th most common cause of medical retinopathy after age related macular degeneration (ARMD), retinal venous occlusion (RVO) and diabetic retinopathy (DR).[2]
Many risk factors have been associated with CSCR including type A personality, smoking, hypertention, pregnancy, male gender, anxiety, stress, gastroesophagial reflux disease (GERD), H.pylori, both exogenous and endogenous steroids.[4]
Chronic CSCR was defined for this study as the one in which Subretinal fluid (SRF) didn’t resolve after an observation period of minimum three months

Summary

INTRODUCTION

CSCR is a sight threatening condition associated with serous exudation between pigmentary and neurosensory retinal causing a localized retinal detachment.1CSCR is considered 4th most common cause of medical retinopathy after age related macular degeneration (ARMD), retinal venous occlusion (RVO) and diabetic retinopathy (DR).[2]. Many risk factors have been associated with CSCR including type A personality, smoking, hypertention, pregnancy, male gender, anxiety, stress, gastroesophagial reflux disease (GERD), H.pylori, both exogenous and endogenous steroids.[4]. Acetazolamide, rifampicin, finasteride, ketoconazole and anti H.pylori treatment has been studied by various authors with no definitive evidence in any large randomized control trial. None of these is so far accepted as a definitive treatment. Purpose of this study was to determine the efficacy of this new treatment modality, eplerenone in patients with CSCR

METHODS

RESULTS

DISCUSSION