Visual and anatomical outcomes of spironolactone therapy in patients with chronic central serous chorioretinopathy

Purpose: to evaluate the effect of spironolactone on chronic central serous chorioretinopathy (csc). methods: in this prospective interventional case series,patients with chronic csc were treated with spironolactone (25 mg daily) for at least 6 weeks. if the subretinal fluid (srf) had not completely resolved by this time,treatment was continued,and the dosage was increased to 25 mg twice daily. primary outcome measure was the change in maximum srf height at the final follow-up visit,as detected by optical coherence tomography. secondary outcome measures were changes in best corrected visual acuity (bcva) and central macular thickness (cmt). results: sixteen eyes of 14 patients with chronic csc were enrolled. mean follow-up time was 6.4 ± 4.3 months. baseline bcva was 0.54 ± 0.44 logarithm of the minimum angle of resolution (log mar),which improved to 0.42 ± 0.43 log mar at the final visit (p = 0.04). mean cmt decreased from 282.69 ± 103.23 μm at baseline to 236.75 ± 90.10 μm at final visit (p = 0.11),and the mean of maximum srf height decreased from 155.63 ± 95.27 μm at baseline to 77.19 ± 95.68 μm at the final visit (p = 0.04). srf resolved completely in seven eyes (43.75%). conclusion: in eyes with persistent srf due to csc,spironolactone therapy was associated with a statistically significant decrease in maximum srf height,as well as an improvement in bcva. falavarjani khalil 1 eye research center,rassoul akram hospital,iran university of medical sciences,tehran amirsardari anahita 2 eye research center,rassoul akram hospital,iran university of medical sciences,tehran habibi abbas 3 eye research center,rassoul akram hospital,iran university of medical sciences,tehran eshaghi acieh 4 eye research center,rassoul akram hospital,iran university of medical sciences,tehran bakhti shohreh 5 eye research center,rassoul akram hospital,iran university of medical sciences,tehran aghdam kaveh 6 eye research center,rassoul akram hospital,iran university of medical sciences,tehran daruich a,matet a,dirani a,bousquet e,zhao m,farman n,et al. central serous chorioretinopathy: recent findings and new physiopathology hypothesis. prog retin eye res 2015;48:82-118. wong kh,lau kp,chhablani j,tao y,li q1,wong iy. central serous chorioretinopathy: what we have learnt so far. acta ophthalmol 2016;94:321-325. kitzmann as,pulido js,diehl nn,hodge do,burke jp. the incidence of central serous chorioretinopathy in olmsted county,minnesota,1980-2002. ophthalmology 2008;115:169-173. spaide rf,campeas l,haas a,yannuzzi la,fisher yl,guyer dr,et al. central serous chorioretinopathy in younger and older adults. ophthalmology 1996;103:2070-2079; 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