Title Spironolactone for chronic central serous chorioretinopathy - a pilot study

Abstract AIM To estimate the efficacy of oral spironolactone in patients with chronic central serous chorioretinopathy (CSC). METHODS This was a pilot study consisting of patients who were diagnosed with chronic central serous chorioretinopathy for at least a 6-month duration. This study included 75 eyes of 74 patients who were treated with spironolactone (20 mg orally, twice daily) for 8 weeks. The best corrected visual acuity (BCVA), subretinal fluid (SRF), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were each measured at baseline, 4 weeks and 8 weeks. RESULTS In our study, 75 eyes of 74 patients (49 men and 25 women) were included. The mean BCVA was 0.39 ± 0.25 at baseline, 0.29 ± 0.19 at 4 weeks and 0.23 ± 0.19 at 8 weeks. The BCVA at 4 weeks and 8 weeks was significantly improved compared to the baseline BCVA (p = 0.000). The mean SRF and the mean CMT decreased significantly at 4 weeks and 8 weeks (p = 0.000). The mean SFCT decreased slightly at 4 weeks and 8 weeks but without significance compared to the baseline (p = 0.654). CONCLUSION Spironolactone can competitively bind to mineralocorticoid receptors (MRs), reduce glucocorticoid binding or reduce endogenous activation of MR. It is possible to improve the visual acuity and safety of patients with chronic CSC by reducing the high permeability of the choroid membrane and by promoting the absorption of the subretinal fluid.