title: Mineralocorticoid Antagonists as Adjuncts in Neovascular Age-Related Macular Degeneration.
abstract: BACKGROUND
  The purpose of this project was to evaluate the role of MR antagonists as an adjunct in patients with neovascular age-related macular degeneration (AMD) who have chronic subretinal fluid.
  
  
  METHODS
  Inclusion criteria were patients with a diagnosis of neovascular AMD, who had completed at least six anti-VEGF injections, and had persistent subretinal fluid (SRF) on optical coherence tomography (OCT). Treatment with oral eplerenone was initiated and dose titrated according to protocol.
  
  
  RESULTS
  23 patients were included in the study (mean age = 54.6, 52.2% female, 47.8% male). 13 of the 23 patients had predominantly chronic subretinal fluid without large PEDs. In this subgroup, mean initial central macular thickness (CMT) prior to starting oral eplerenone was 305.3 μm, and mean injection interval was 40.25 days. Mean final CMT after at least 3 months of adjunctive eplerenone treatment was 240.6 μm and mean injection interval with adjunctive treatment was 54.61 days. Mean extension of the injection interval after commencing oral eplerenone was 14.36 days.
  
  
  CONCLUSIONS
  These findings suggest oral MR antagonists may have a role as an adjunctive treatment in neovascular AMD, and may be particularly useful in dehydration of the subretinal space in the setting of chronic subretinal fluid. Further research is needed in randomized controlled trials to elucidate the precise role of oral MR antagonists in neovascular AMD.
authors.affiliation: Wagner Macula and Retina Center, Eastern Virginia Medical School, Virginia Beach, VA, USA. Kaps2003@gmail.com.
authors.forename: Kapil G
authors.initials: KG
authors.lastname: Kapoor
authors.affiliation: Wagner Macula and Retina Center, Eastern Virginia Medical School, Virginia Beach, VA, USA.
authors.forename: Niket
authors.initials: N
authors.lastname: Todi
authors.affiliation: Wagner Macula and Retina Center, Eastern Virginia Medical School, Virginia Beach, VA, USA.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Wagner
keywords: Central serous retinopathy; Mineralocorticoid antagonists; Neovascular AMD; Subretinal fluid; Wet AMD