Oral Eplerenone for Treatment of Chronic Central Serous Chorioretinopathy: A Case Series

Abstract

Oral eplerenone may be effective in treating patients with chronic CSCR.

Central Serous Chorioretinopathy Treatments: A Mini Review

“…Also, the efficacy of eplerenone for the treatment of chronic CSC was investigated in some case series, each with a short-term follow-up [63,64,65,66,67]. Two recent retrospective studies provided evidence of beneficial effects of oral eplerenone on BCVA improvement and in the reduction of the height of the NSD.…”

“…Two recent retrospective studies provided evidence of beneficial effects of oral eplerenone on BCVA improvement and in the reduction of the height of the NSD. Salz et al [63] reported a statistically significant improvement from the baseline BCVA of 0.40 LogMAR to 0.27 at 3 months and a significant mean reduction of the subretinal fluid by 100 µm in 14 patients. Only a trend in the mean reduction of the choroidal thickness was correspondingly observed.…”

“…Considering all the studies, a complete NSD resolution was detected in 35-67% of cases and no significant adverse events were registered. The studies differed with regard to dose administration of the oral eplerenone; in detail, the study by Singh et al [64] employed 25 or 50 mg per day, whereas Bousquet et al [67] and Salz et al [63] assigned 25 g of eplerenone per day during the first week followed by 50 mg daily until the 3-month examination.…”

Finasteride is effective for the treatment of central serous chorioretinopathy

“…Because of the known association with glucocorticosteroids, the most widely studied oral agents for the treatment of CSC are anti-glucocorticoids, such as ketoconazole, 20,21 mifepristone, 22,23 and rifampin. [24][25][26] Other reports investigated anti-mineralocorticoids, such as eplerenone [43][44][45][46] and spironolactone, 47,48 as well as carbonic anhydrase inhibitors (acetazolamide). 49 We note that all these series were small (under 20 patients) with relatively short follow-up, and reported mixed results.…”

“…50 Reduction of CMT and improvement in VA was reported with the antimineralocorticoids, but it should be noted that these agents can cause low blood pressure, hyperkalemia, and other adverse effects. [43][44][45][46][47][48] Acetazolamide was shown to reduce CMT but had no effect on VA, and it too can cause low blood pressure and other adverse effects. 49 Finasteride is approved by the FDA for the treatment of benign prostatic hyperplasia (BPH) and androgenic alopecia, and is known to have an excellent safety profile, [51][52][53] and has also been shown to have fewer side effects and drug interactions than ketoconazole.…”