title: Mineralocorticoid receptor antagonism in the treatment of chronic central serous chorioretinopathy: a pilot study.
abstract: OBJECTIVE
  Based on experimental data showing that central serous chorioretinopathy could result from overactivation of mineralocorticoid receptor pathway in choroid vessels, the authors studied eplerenone, a mineralocorticoid receptor antagonist, as a potential treatment for chronic central serous chorioretinopathy.
  
  
  METHODS
  This nonrandomized pilot study included 13 patients with central serous chorioretinopathy of at least 4-month duration, treated with 25 mg/day of oral eplerenone for a week followed by 50 mg/day for 1 or 3 months. The primary outcome measure was the changes in central macular thickness recorded by optical coherence tomography, and the secondary outcomes included changes in foveal subretinal fluid (SRF) measured by OCT, in best-corrected visual acuity (BCVA) and the percentage of eyes achieving complete resolution of subretinal fluid during the treatment period.
  
  
  RESULTS
  Central macular thickness decreased significantly from 352 ± 139 μm at baseline to 246 ± 113 μm and 189 ± 99 μm at 1 and 3 months under eplerenone treatment (P < 0.05 and P < 0.01, respectively). At 3 months, the subretinal fluid significantly decreased compared with baseline subretinal fluid (P < 0.01) and best-corrected visual acuity significantly improved compared with baseline best-corrected visual acuity (P < 0.001).
  
  
  CONCLUSIONS
  Eplerenone treatment was associated with a significant reduction in central macular thickness, subretinal fluid level, and an improvement in visual acuity. Randomized controlled trials are needed to confirm these encouraging results.
authors.affiliation: *INSERM U872, University Rene Descartes Sorbonne Paris Cité, Team 17, Cordeliers Research Center, Paris, France; †University Rene Descartes Sorbonne, Paris Cité, France; and ‡Assistance Publique des Hôpitaux de Paris, Hôtel-Dieu, Paris, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Bousquet
authors.forename: Talal
authors.initials: T
authors.lastname: Beydoun
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.forename: Leila
authors.initials: L
authors.lastname: Hassan
authors.forename: Olivier
authors.initials: O
authors.lastname: Offret
authors.forename: Francine
authors.initials: F
authors.lastname: Behar-Cohen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy*; D002908:Chronic Disease; D000077545:Eplerenone; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008266:Macula Lutea / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D058471:Subretinal Fluid / Q000187:drug effects / Q000378:metabolism; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone