title: Spironolactone in the treatment of central serous chorioretinopathy - a case series.
abstract: BACKGROUND
  The pathogenesis of central serous chorioretinopathy (CSC) is still poorly understood. An animal model of CSC proved that the mineralocorticoid receptor [1] of the choroid also plays a role in CSC. Since there is still no evidence-based therapy for non-self-limiting CSC, this case series evaluates the effect of oral spironolactone in CSC patients.
  
  
  METHODS
  In this interventional, uncontrolled, prospective case series, we present 18 consecutive CSC patients. Patients were treated with spironolactone 25 mg twice daily (Spironolacton AL® 50 mg, ALIUD PHARMA) for up to 12 weeks. Follow-up examinations with BCVA, OCT, and EDI-OCT were performed at 1, 2, and 3 months after starting the treatment. Main outcome measure was a change of subretinal fluid (SRF) (in micrometers) measured by optical coherence tomography. Secondary outcome was a change in central retinal thickness (CRT) (in micrometers) measured by OCT and a change in BCVA.
  
  
  RESULTS
  The subretinal fluid (SRF; mean) decreased from 219 μm (baseline) to 100 μm (visit 3) (difference 119 μm). Total central retinal thickness (CRT; mean) decreased from 405 μm before treatment (baseline) to 287 μm after treatment (difference 118 μm). The BCVA (in logMAR; mean) increased from 0.32 at baseline to 0.20 at visit 3.
  
  
  CONCLUSIONS
  Our case series could confirm a positive influence of spironolactone on the course CSC. Longer follow-up with a larger number of cases could provide more data about the long-term efficiency, recurrences, and safety of this well-tolerated and non-invasive treatment option of CSC.
authors.affiliation: Department of Ophthalmology, University Eye Hospital - LMU, Campus Innenstadt, Klinikum der Universität München, Mathildenstrasse 8, D-80336, Munich, Germany, Tina.herold@med.uni-muenchen.de.
authors.forename: T R
authors.initials: TR
authors.lastname: Herold
authors.forename: K
authors.initials: K
authors.lastname: Prause
authors.forename: A
authors.initials: A
authors.lastname: Wolf
authors.forename: W J
authors.initials: WJ
authors.lastname: Mayer
authors.forename: M W
authors.initials: MW
authors.lastname: Ulbig
mesh_terms: D000284:Administration, Oral; D000328:Adult; D056833:Central Serous Chorioretinopathy / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011446:Prospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone