Spironolactone versus observation in the treatment of acute central serous chorioretinopathy

Br J Ophthalmol. 2018 Aug;102(8):1060-1065. doi: 10.1136/bjophthalmol-2017-311096. Epub 2017 Oct 31.

Abstract

Purpose: To evaluate the efficacy of oral spironolactone in patients with acute central serous chorioretinopathy (CSC).

Methods: This is a prospective, randomised controlled clinical study. Thirty patients with acute CSC were the participants, including 18 patients who were treated with spironolactone (40 mg orally, twice daily) for 2 months in the experimental group and 12 patients who received observation in the control group. Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid (SRF), changes in central macular thickness (CMT), the height of SRF (SRFH), best corrected visual acuity (BCVA) 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 the eyes in the treatment group and the control group, respectively, at 2 months (p=0.018). The mean CMT and SRFH decreased significantly at each visit in both groups (p<0.05), and there was significant difference between the two groups at 2 months (p<0.05 and p<0.05, respectively). BCVA (in logarithm of the minimum angle of resolution; mean) improved in both groups at 2 months (p<0.05). In the treatment group, the mean baseline SFCT significantly decreased from 502.50±87.38 µm to 427.44±74.37 µm at 2 months (p<0.01), while the change from baseline (from 480.33±102.38 µm to 463.75±100.63 µm) was not significant in the control group (p=0.195). But the differences between the two groups in BCVA and SFCT were not significant.

Conclusions: Oral spironolactone is more effective with a faster absorption of SRF than observations. It is a promising treatment for acute CSC.

Trial registration number: ChiCTR-IPR-16008428, Results.

Keywords: choroid; macula; retina; treatment medical.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adult
  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / drug therapy*
  • Central Serous Chorioretinopathy / physiopathology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Observational Studies as Topic
  • Prospective Studies
  • Spironolactone / therapeutic use*
  • Subretinal Fluid
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Mineralocorticoid Receptor Antagonists
  • Spironolactone

Associated data

  • ChiCTR/ChiCTR-IPR-16008428