Spironolactone In The Treatment Of Central Serous Chorioretinopathy

Purpose:To evaluate the efficacy of oral spironolactone,a mineralocorticoid receptor antagonist(MRa),compared with observation in patients with acute central serous chorioretinopathy(CSC).Methods:This is a prospective,randomized,controlled clinical study.Thirty patients with acute CSC were participants,including 18 patients who were treated with spironolactone(40mg p.o.b.i.d.)for two months in the experimental group and 12 patients who received observation in the control group.All patients underwent fundus fluorescein angiography(FFA),best corrected visual acuity(BCVA),enhanced depth imaging spectral-domain optical coherence tomography(EDI-OCT)and serum aldosterone level at baseline.At each follow-up visit,BCVA and EDI-OCT were performed again.Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid(SRF),change in BCVA,central macular thickness(CMT),the height of SRF(SRFH)and subfoveal choroidal thickness(SFCT).The follow-up period was 2 months.Results:Complete resolution of SRF was achieved in 55.6%(10/18)and 8.3%(1/12)of eyes in the MRa group and the control group respectively at 2 month(P<0.05).The mean CMT and SRFH decreased significantly at each visit compared to baseline in both groups(P<0.05),and there was significant difference between the two groups at 2 months(P=0.048,P=0.017,respectively).BCVA(in logMAR;mean)improved from 0.25±0.18 at baseline to 0.05±0.09 at 2 months(P<0.01)in the treatment group.The mean BCVA of the control group improved from 0.25±0.22 at baseline to 0.14±0.18(P<0.05)at 2 months.In the treatment group,the mean baseline SFCT significantly decreased from 502.50±87.38?m to 427.4±74.37?m at 2 months(P<0.01)while the change from baseline(from 480.33±02.38?m to 463.75±100.63?m)was not significant in the control group(P>0.05).But the differences between two groups in BCVA and SFCT were not significant.Conclusions:Oral spironolactone is more effective with a faster absorption of SRF than observation.Oral spironolactone is a promising treatment of acute CSC.