J Korean Ophthalmol Soc.  2018 Jun;59(6):511-518. 10.3341/jkos.2018.59.6.511.

Comparison of Short-term Clinical Outcomes between Oral Spironolactone and Observation in Acute Central Serous Chorioretinopathy

• Lee JY
• Kim DY
• Lee EK
• Lee SY
• Lee HJ
• Jeong JH
• Kim JY

• KMID: 2413813
• DOI: http://doi.org/10.3341/jkos.2018.59.6.511

Abstract

PURPOSE
To compare the short-term efficacy of oral spironolactone vs. observation in patients with acute central serous chorioretinopathy.
METHODS
Forty-seven eyes of 47 patients diagnosed as acute central serous chorioretinopathy from January 2013 to June 2016 were treated with oral spironolactone or were observed. This was a retrospective study involving patients analyzed for changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid height (SRFH).
RESULTS
Oral spironolactone was used to treat 24 eyes and 23 eyes were observed. There were no differences in baseline characteristics including age, sex, BCVA (logMAR), CMT, and SRFH between the two groups. The mean BCVA, CMT, and SRFH improved compared with baseline at 1 month and 2 months in both groups. In comparison between the two groups, the mean BCVA of oral spironolactone group improved more than in the observation group at 2 months (p = 0.006). There was a significant difference in CMT between the two groups at 1 month and 2 months (p = 0.017 and p < 0.001, respectively), and there was a significant difference in subretinal fluid height between the two groups at 2 months (p = 0.007). Complete resolution of subretinal fluid was achieved in 33.3% (8/24) and 21.7% (5/23) of the eyes in the oral spironolactone group and the observation group, respectively, at 2 months (p = 0.374). There was no serious side effect in patients treated with oral spironolactone.
CONCLUSIONS
Both oral spironolactone and observation were effective for the treatment of acute central serous chorioretinopathy. Oral spironolactone was more effective than observation when comparing the best-corrected visual acuity, central macular thickness, and subretinal fluid height. As a noninvasive method for treatment of acute central serous chorioretinopathy, oral spironolactone showed anatomical improvement and improved visual acuity during a short-term period.

Keyword

Central serous chorioretinopathy; Observation; Spironolactone

MeSH Terms

Central Serous Chorioretinopathy*
Humans
Methods
Retrospective Studies
Spironolactone*
Subretinal Fluid
Visual Acuity
Spironolactone

Figure

• 

  Figure 1. Comparison of mean best corrected visual acuity (BCVA, logMAR) between the groups over time. Spironolactone group showed significant difference at 1 and 2 months compared with baseline. No significant difference was found during follow-up period in observation group. There was a statistically significant difference between spironolactone and observation group at 2 months. Error bars represent standard errors. * p < 0.05 compared between groups.

• 

  Figure 2. Comparison of mean central macular thickness (CMT, μ m) between the groups over time. Spironolactone group showed significant difference at 1 and 2 months compared with baseline. In observation group, a significant decrease was shown at 2 months. A significant difference in CMT between the groups was observed at 1 and 2 months. Error bars *p < 0.05 compared between represent standard errors. groups.

• 

  Figure 3. Comparison of mean subretinal fluid height (SRFH, μ m) between the groups over time. Both groups showed a significant difference at 1 month, 2 months compared with baseline. A significant difference in SRFH between the groups was observed at 2 months. Error bars represent standard errors. * p < 0.05 compared between groups.

• 

  Figure 4. Macular thickness map and optical coherence tomography (OCT) scan of the patients with central serous chorioretinopathy (CSC). OCT images of a 48-year-old man with CSC at baseline (A), at 1 month (B), and 2 months (C) after observation. OCT images of 54-years-old man with CSC at baseline (D), at 1 month (E), and 2 months (F) after oral spironolactone.

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