Elodie Bousquet1, Myriam Dhundass2, Raphaël Lejoyeux2, Ari Shinojima3, Valérie Krivosic4, Sarah Mrejen5, Alain Gaudric4, Ramin Tadayoni4. 1. Department of Ophthalmology, Hôpital Cochin, OphtalmoPôle, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: bousquetelodie@hotmail.fr. 2. Department of Ophthalmology, Hôpital Cochin, OphtalmoPôle, Assistance Publique-Hôpitaux de Paris, Paris, France. 3. Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan. 4. Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France. 5. Department of Ophthalmology, Centre Hospitalier National des Quinze-Vingts, Université Pierre et Marie Curie Paris, Paris, France.
Abstract
PURPOSE: To assess the efficacy and safety of mineralocorticoid receptor antagonists (MRAs) in the treatment of nonresolving central serous chorioretinopathy (CSC) and to identify factors that are predictive of treatment response. DESIGN: Retrospective, multicenter, noncomparative, interventional case series. METHODS: Clinical and imaging data from consecutive patients with nonresolving CSC treated with eplerenone or spironolactone for 3 to 6 months between 2012 and 2016 were reviewed. Outcome measures included the resolution of foveal subretinal detachment (SRD), changes in SRD height, central macular thickness, subfoveal choroidal thickness, best corrected visual acuity, and the occurrence of adverse events assessed at 3 and 6 months. The response to treatment was defined by a decrease by >50% in SRD height under treatment. Comparisons between responder and nonresponder groups were performed using univariate and multivariate regression analyses to identify factors that were predictive of treatment response. RESULTS: Fifty-nine patients (64 eyes) were included. The mean SRD height and central macular thickness significantly decreased while the mean best corrected visual acuity significantly improved at 3 and 6 months. The mean subfoveal choroidal thickness significantly decreased at 3 months. Among the 64 eyes included, 67.2% responded to treatment, among which 38.3% and 40.5% had a complete resolution of the foveal SRD at 3 and 6 months, respectively. Baseline subfoveal choroidal thickness was the only factor associated with a treatment response in the multivariate analysis. CONCLUSION: Our study suggests that MRA could be a safe and effective treatment in patients with nonresolving CSC. MRA treatment is more effective in cases with a thicker baseline choroid.
PURPOSE: To assess the efficacy and safety of mineralocorticoid receptor antagonists (MRAs) in the treatment of nonresolving central serous chorioretinopathy (CSC) and to identify factors that are predictive of treatment response. DESIGN: Retrospective, multicenter, noncomparative, interventional case series. METHODS: Clinical and imaging data from consecutive patients with nonresolving CSC treated with eplerenone or spironolactone for 3 to 6 months between 2012 and 2016 were reviewed. Outcome measures included the resolution of foveal subretinal detachment (SRD), changes in SRD height, central macular thickness, subfoveal choroidal thickness, best corrected visual acuity, and the occurrence of adverse events assessed at 3 and 6 months. The response to treatment was defined by a decrease by >50% in SRD height under treatment. Comparisons between responder and nonresponder groups were performed using univariate and multivariate regression analyses to identify factors that were predictive of treatment response. RESULTS: Fifty-nine patients (64 eyes) were included. The mean SRD height and central macular thickness significantly decreased while the mean best corrected visual acuity significantly improved at 3 and 6 months. The mean subfoveal choroidal thickness significantly decreased at 3 months. Among the 64 eyes included, 67.2% responded to treatment, among which 38.3% and 40.5% had a complete resolution of the foveal SRD at 3 and 6 months, respectively. Baseline subfoveal choroidal thickness was the only factor associated with a treatment response in the multivariate analysis. CONCLUSION: Our study suggests that MRA could be a safe and effective treatment in patients with nonresolving CSC. MRA treatment is more effective in cases with a thicker baseline choroid.
Authors: Jae Yong Han; Yong Joon Kim; Eun Young Choi; Junwon Lee; Ji Hwan Lee; Min Kim; Suk Ho Byeon; Sung Soo Kim; Christopher Seungkyu Lee Journal: Yonsei Med J Date: 2022-04 Impact factor: 2.759