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

Abstract

To evaluate the efficacy and safety of eplerenone for chronic nonresolving central serous chorioretinopathy (CSC). Prospective, double-blind, randomized placebo-controlled study. Nineteen eyes of 17 patients with persistent subretinal fluid (SRF) due to CSC were enrolled and randomized to receive eplerenone 50mg/day or placebo for 3months, followed by a 3-month follow-up. The main outcome measure was change in SRF from baseline to 3months of treatment. Secondary outcomes included change in SRF at any time-point, complete resolution of SRF, improvement in choroidal thickness and change in best-corrected visual acuity (BCVA). Thirteen eyes were treated with eplerenone and six with placebo. Both groups showed reduction in SRF throughout the treatment period, with a significant reduction at months 1, 3 and 5 only in the treatment group. Twenty-three per cent in the treatment group and 30.8% per cent in the placebo group experienced complete resolution of SRF. A significant improvement in BCVA was noted in the placebo group at 4months, as well as a significant difference in BCVA between groups at 3months in favour of the placebo group (p=0.005). There was no significant difference in choroidal thickness in either group throughout the study period. No adverse events related to eplerenone were noted in the treatment group. In this study, eplerenone was not found to be superior to placebo in eyes with chronic CSC.