Literature DB >> 28426624

A RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROL PILOT STUDY OF EPLERENONE FOR THE TREATMENT OF CENTRAL SEROUS CHORIORETINOPATHY (ECSELSIOR).

Ehsan Rahimy1,2, John D Pitcher1,3, Jason Hsu1, Murtaza K Adam1, Abtin Shahlaee1, Wasim A Samara1, James F Vander1, Richard S Kaiser1, Allen Chiang1, Marc J Spirn1, Mitchell S Fineman1.   

Abstract

PURPOSE: To evaluate the safety and effects of oral eplerenone in chronic central serous chorioretinopathy.
METHODS: Prospective, randomized, double-blind, placebo-control study at a tertiary referral academic private practice. For a diagnosis of chronic central serous chorioretinopathy, patients must have had at least 3 months clinical follow-up demonstrating persistent symptoms, subfoveal fluid on spectral-domain optical coherence tomography, and <50% reduction in fluid thickness. Patients were randomized 2:1 (treatment:placebo) to receive eplerenone (25 mg daily for 1 week, then up to 50 mg daily for 8 weeks) or placebo once daily.
RESULTS: Fifteen patients completed the study. Ten patients (15 eyes) were randomized into the eplerenone treatment arm, while the remaining 5 patients (6 eyes) received placebo. After 9 weeks of eplerenone therapy, mean logarithm of the minimal angle of resolution visual acuity improved from 0.394 (Snellen equivalent: 20/50) to 0.330 (20/43, P = 0.04). In the placebo group, the mean logarithm of the minimal angle of resolution visual acuity slightly decreased from 0.313 (20/41) to 0.342 (20/44) during the same period (P = 0.21). With respect to anatomic changes, mean maximal subretinal fluid height in the eplerenone group improved from 139.3 μm at baseline to 51.8 μm (P = 0.02), mean subfoveal fluid height improved from 121.4 μm to 29.4 μm (P = 0.01), and mean central subfield thickness improved from 366.2 μm to 283.7 μm (P = 0.02). In comparison with the placebo group, mean maximal subretinal fluid height worsened from 135.9 μm to 172.3 μm (P = 0.32), mean subfoveal fluid height worsened from 92.1 μm to 134.0 μm (P = 0.54), and mean central subfield thickness worsened from 345.0 μm to 380.0 μm (P = 0.37). No patients in either group experienced serious adverse events to result in treatment discontinuation.
CONCLUSION: These findings suggest that oral eplerenone therapy is safe and potentially effective in the treatment of chronic central serous chorioretinopathy with persistent subretinal fluid.

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Year:  2018        PMID: 28426624     DOI: 10.1097/IAE.0000000000001649

Source DB:  PubMed          Journal:  Retina        ISSN: 0275-004X            Impact factor:   4.256


  18 in total

Review 1.  [Statement and recommendation of the Professional Association of German Ophthalmologists (BVA), the German Ophthalmological Society (DOG) and the German Retina Society (RG) on central serous chorioretinopathy : Situation January 2018].

Authors: 
Journal:  Ophthalmologe       Date:  2018-05       Impact factor: 1.059

Review 2.  [Statement of the Professional Association of Ophthalmologists in Germany (BVA), the German Ophthalmological Society (DOG) and the Retinological Society (RG) on central serous chorioretinopathy : Status 18 October 2021].

Authors: 
Journal:  Ophthalmologe       Date:  2021-12-14       Impact factor: 1.059

3.  Mineralocorticoid receptor antagonists for chronic central serous chorioretinopathy: systematic review and meta-analyses.

Authors:  Camila Q Felipe; Ana Luiza Biancardi; Vinicius T Civile; Nelson Carvas Junior; Pedro D Serracarbassa; Marcia K Koike
Journal:  Int J Retina Vitreous       Date:  2022-06-07

Review 4.  Statement of the Professional Association of Ophthalmologists in Germany (BVA), the German Society of Ophthalmology (DOG) and the German Retina Society (RG) on central serous chorioretinopathy : Status 18 October 2021.

Authors: 
Journal:  Ophthalmologie       Date:  2022-04-06

Review 5.  Oral medications for central serous chorioretinopathy: a literature review.

Authors:  William Fusi-Rubiano; Habiba Saedon; Vijay Patel; Yit C Yang
Journal:  Eye (Lond)       Date:  2019-09-16       Impact factor: 3.775

Review 6.  Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options.

Authors:  Francesco Sartini; Michele Figus; Marco Nardi; Giamberto Casini; Chiara Posarelli
Journal:  Eye (Lond)       Date:  2019-03-01       Impact factor: 3.775

7.  Minoxidil induced central serous Chorioretinopathy treated with oral Eplerenone - a case report.

Authors:  Ramesh Venkatesh; Arpitha Pereira; Kushagra Jain; Naresh Kumar Yadav
Journal:  BMC Ophthalmol       Date:  2020-06-05       Impact factor: 2.209

Review 8.  Central serous chorioretinopathy: Current update on management.

Authors:  George Joseph Manayath; Ratnesh Ranjan; Smita S Karandikar; Vanee Sheth Shah; Veerappan R Saravanan; Venkatapathy Narendran
Journal:  Oman J Ophthalmol       Date:  2018 Sep-Dec

Review 9.  Eplerenone in the treatment of central serous chorioretinopathy: a review of the literature.

Authors:  Irini Chatziralli; Aikaterini Vlachodimitropoulou; Chrysoula Daoula; Christina Vrettou; Eleni Galani; George Theodossiadis; Panagiotis Theodossiadis
Journal:  Int J Retina Vitreous       Date:  2018-09-19

Review 10.  Management of chronic central serous chorioretinopathy.

Authors:  Daren Hanumunthadu; Anna C S Tan; Sumit Randhir Singh; Niroj Kumar Sahu; Jay Chhablani
Journal:  Indian J Ophthalmol       Date:  2018-12       Impact factor: 1.848

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