Oral Eplerenone for the Management of Acute Serous Chorioretinopathy

To determine whether Eplerenone (Inspra,Pfizer), a mineralocorticoid receptor (MR) antagonist, is an effective treatment option for acute central serous chorioretinopathy (CSCR). A prospective analysis was conducted for patients who received off-label oral Eplerenone for the treatment of acute CSCR. Eplerenone was administered orally at a dose of 50mg daily, for a total of 28 days. Patients were observed at baseline and at 3 separate consult visits: 7; 14 and 28 days, with SD-OCT performed at each follow-up.The primary outcome measure of the study, was the best corrected visual acuity (BCVA) following Eplerenone administration. A prospective cohort of 15 eyes in 15 patients with acute CSCR were treated with 50mg/d Eplerenone for 28 days. After 28 days, statistically significant decreases from the baseline were observed in, SRF diameter (P<0.01), SRF height (P=0.001), CST (P<0.01), CV(P<0.01), and CAT (P=0.01). After 28 days, the BCVA was 0.9 +/- 0.1 (P=0.001), compared to baseline BCVA 0.8 +/- 0.1. Complete resolution of subretinal fluid (SRF) was seen in 8 out of 15 (53.3%) eyes. Eplerenone treatment accelerated SRF in acute CSCR, compared to the natural disease course.