title: Long-term Resolution of Blinding Polypoidal Choroidal Vasculopathy with Recurrent Bilateral Central Involvement by Low-dose Oral Eplerenone Treatment.
abstract: A 55-year-old male presented with serous retinal detachment over 3 months in his right eye. His left eye was blind due to retinal pigment epithelium detachment since 1997 with atrophy of the neurosensory retina. Fluorescein angiography had previously shown bilateral polypoidal choroidal vasculopathy (PCV). Optical coherence tomography (OCT) confirmed PCV with central involvement. The patient underwent intravitreal injections of 6x Lucentis, 4x Avastin and one injection of aflibercept. PCV recurred from 1 to 4 months after each treatment. The patient had history of stroke, hypertension, and atrial fibrillation and was started on oral eplerenone 25 mg/day in October 2014, which resulted in a long-term ongoing complete retinal reattachment. OCT ganglion cell and inner plexiform layers showed full recovery of the fovea in the right eye and irreversible in the left eye. Low-dose eplerenone may resolve recalcitrant PCV with central involvement. The duration of treatment remains uncertain.
authors.affiliation: Department of Ophthalmology, Al-Ahli Hospital, Doha, Qatar, Qatar.
authors.forename: Alexander Arthur
authors.initials: AA
authors.lastname: Bialasiewicz
authors.affiliation: Department of Ophthalmology, Al-Ahli Hospital, Doha, Qatar, Qatar.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abdelhamid
authors.affiliation: Department of Ophthalmology, Armed Forces Hospital, Muscat, Qatar.
authors.forename: Radha
authors.initials: R
authors.lastname: Shenoy
authors.affiliation: Department of Cardiology, Al-Ahli Hospital, Doha, Qatar, Qatar.
authors.forename: Manish
authors.initials: M
authors.lastname: Barman
mesh_terms: D000284:Administration, Oral; D001766:Blindness / Q000534:rehabilitation*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D000077545:Eplerenone; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage*; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy*; D012008:Recurrence; D013148:Spironolactone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone
keywords: Aldosterone Antagonist; Central Serous Retinal Detachment; Eplerenone; Polypoidal Choroidal Vasculopathy; Ranibizumab