title: Central serous chorioretinopathy in primary hyperaldosteronism.
abstract: OBJECTIVE
  To describe ophthalmological characteristics of 13 patients with primary hyperaldosteronism (PA).
  
  
  METHODS
  Cross-sectional study. All patients underwent extensive ophthalmological examination.
  
  
  RESULTS
  Thirteen PA patients (9 male, 4 female) were diagnosed with arterial hypertension for 11.0 ± 11.2 years. Ophthalmological imaging revealed macular serous subretinal fluid (SRF) on optical coherence tomography in 2 patients (15 %). In one of these patients, bilateral chronic central serous chorioretinopathy (CSC) with polypoidal choroidal neovasculopathy was diagnosed, which was effectively treated with full-dose photodynamic therapy. In the other patient with SRF and bilateral diffuse hyperfluorescent areas on fluorescein angiography, the SRF had decreased spontaneously after 6 weeks of follow-up. In 5 of the remaining patients (38 %), retinal pigment epithelium alterations resembling findings characteristic for CSC were seen on multimodal imaging. The mean subfoveal choroidal thickness was 290.2 ± 65.0 μm.
  
  
  CONCLUSIONS
  Retinal abnormalities resembling (subclinical) CSC are common in patients with PA. These findings indicate that mineralocorticoid-mediated pathways are involved in the pathogenesis of CSC. In CSC patients with hypertension of unknown origin, a diagnosis of PA should be considered.
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Department J3-S, PO Box 9600, 2300RC, Leiden, Netherlands.
authors.forename: Elon H C
authors.initials: EH
authors.lastname: van Dijk
authors.affiliation: Department of Medicine, Division of Nephrology and Transplantation, Leiden University Medical Center, Leiden, Netherlands.|Department of Medicine, Division of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Nijhoff
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Eiko K
authors.initials: EK
authors.lastname: de Jong
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, Netherlands.|Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Onno C
authors.initials: OC
authors.lastname: Meijer
authors.affiliation: Department of Medicine, Division of Nephrology and Transplantation, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Aiko P J
authors.initials: AP
authors.lastname: de Vries
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Department J3-S, PO Box 9600, 2300RC, Leiden, Netherlands. c.j.f.boon@lumc.nl.
authors.forename: Camiel J F
authors.initials: CJ
authors.lastname: Boon
mesh_terms: D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence
keywords: Central serous chorioretinopathy; Cross-sectional study; Eplerenone; Hyperaldosteronism; Mineralocorticoid antagonist; Spironolactone