Evolution of foveal detachment in dome‐shaped macula after treatment by mineralocorticoids: report of three cases

Abstract

PurposeTo analyze three cases of visual acuity improvement after treatment with spironolactone in patients with dome‐shaped macular and related serous retinal detachment.MethodsWe evaluated four eyes of three patients of 38, 49 and 64 years old with serous retinal detachment associated with dome‐shaped macula. The patients were treated daily with oral spironolactone 50mg. Ophthalmic examination included best‐corrected visual acuity (BCVA) and central retinal thickness (CRT), determines by optical coherence tomography (OCT). They were evaluated on their first visit and on monthly follow‐up visits.ResultsThe first patient's pretreatment BCVA was 20/80 in both eyes; after treatment BCVA improved to 20/50 in the right eye and 20/40 in left eye. Second patient's pretreatment right eye's BCVA was 20/100, and one month after treatment improved to 20/63. The patient stopped the treatment due to a secondary effect (asthenia) and two month later visual acuity declined to 20/80. The last patient's pretreatment BCVA in his right eye was 20/200 and four months after treatment was 20/63.ConclusionsWe evaluated a mineralocorticoid antagonist treatment for serous retinal detachment associated with dome‐shaped macula in myopic patients. One to six months after treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced and there was an improvement in BCVA.