Therapeutic Efficacy of Spironolactone for Central Serous Chorioretinopathy

• Published in: Yonsei medical journal Vol. 63; no. 4; pp. 365 - 371
• Main Authors: Han, Jae Yong, Kim, Yong Joon, Choi, Eun Young, Lee, Junwon, Lee, Ji Hwan, Kim, Min, Byeon, Suk Ho, Kim, Sung Soo, Lee, Christopher Seungkyu
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.04.2022; 연세대학교의과대학
• Subjects: Adult; Aged; Central Serous Chorioretinopathy - diagnosis; Central Serous Chorioretinopathy - drug therapy; Fluorescein Angiography - methods; Humans; Male; Middle Aged; Original; Retrospective Studies; Spironolactone - therapeutic use; Tomography, Optical Coherence - methods; Visual Acuity; 의학일반; Central serous chorioretinopathy; spironolactone; therapeutics
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2022.63.4.365

To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy (CSC). The medical records and imaging data of patients diagnosed with CSC and treated with SPRL were retrospectively reviewed. Central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) at baseline, at 1, 3, and 6 months, and at the last visit after the treatment were analyzed. In total, 103 patients with 107 eyes were included. The mean age of the patients was 51.5±9.3 years, and 77 (72.0%) were male. The mean follow-up duration was 48.6±40.2 weeks. The mean duration of oral SPRL therapy was 15.5±13.4 weeks. CMT, SRF height, and SFCT improved significantly at 1, 3, and 6 months after SPRL therapy and at the last follow-up. BCVA, however, showed no significant change at any time point. The rate of complete resolution of SRF at 1 month was higher in those with chronic CSC than in those with acute CSC (21.1% vs. 6.0%, respectively). Recurrence occurred in 14 (13.1%) eyes after the complete resolution of SRF. Older age ( =0.001), a greater number of previous intravitreal bevacizumab injections ( =0.006), and poor initial visual acuity ( =0.048) were associated with recurrence. No permanent adverse effects were observed. Oral SPRL showed therapeutic benefits in patients with CSC in terms of SRF resolution, but relatively frequent recurrence was observed, especially in older patients.