Ketoconazole in the treatment of chronic idiopathic central serous chorioretinopathy.
OBJECTIVE
To determine the effect of an adrenocorticoid antagonist (ketoconazole) in the treatment of patients with central serous chorioretinopathy (CSC).


METHODS
Ketoconazole was given at an oral dose of 600 mg per day for 4 weeks. Laboratory monitoring included 24-hour urinary cortisol and liver function tests at baseline, 4 weeks, and 8 weeks. Changes in greatest linear dimension were followed with fluorescein angiography at baseline, 4 weeks, and 8 weeks. Posterior pole anatomy was assessed with optical coherence tomography at baseline, 4 weeks, and 8 weeks. Ophthalmic examination and best-corrected visual acuity were assessed at each interval visit.


RESULTS
Median visual acuity in the study eye remained stable at 20/40 throughout the 8-week follow-up. Median lesion height and greatest linear dimension were stable at 4 weeks and decreased at 8 weeks.


CONCLUSIONS
Ketoconazole lowered endogenous cortisol after 4 weeks of 600 mg daily. While median visual acuity, lesion height, and greatest linear dimension remained unchanged during the month of drug treatment, there may have been a delayed therapeutic response seen at 8 weeks.
Meyerle
Catherine B
CB
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear & Throat Hospital, New York, New York, USA.
Freund
K Bailey
KB
Bhatnagar
Pawan
P
Shah
Viral
V
Yannuzzi
Lawrence A
LA
D000284:Administration, Oral; D000328:Adult; D015862:Choroid Diseases / Q000188:drug therapy*; D002908:Chronic Disease; D005451:Fluorescein Angiography; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D007654:Ketoconazole / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D006727:Hormone Antagonists; D007654:Ketoconazole; D006854:Hydrocortisone