Evaluation of Changes in Optical Coherence Tomography (OCT) Biomarkers After Oral Eplerenone Therapy in Chronic Central Serous Chorioretinopathy and Their Correlation to Functional Visual Outcome.

PURPOSE: This study aimed to assess the efficacy of the mineralocorticoid receptor antagonist eplerenone on chronic central serous chorioretinopathy.

METHODS

In this prospective observational study, patients diagnosed with chronic central serous chorioretinopathy fulfilling the inclusion criteria and exclusion criteria were recruited. The best-corrected visual acuity (BCVA) on baseline was noticed, and optical coherence tomography (OCT) parameters (central macular thickness (CMT), subfoveal choroidal thickness (SFCT), subretinal fluid (SRF) height and base, ellipsoid zone (EZ) integrity) were measured at baseline. Participants were then advised about starting the eplerenone 25 mg tablet, and after one month, if serum K+ is <5 mmol/L, the dose was increased to 50 mg for two months. The same variables were assessed after three months.

RESULTS

In this study, BCVA, SFCT, and SRF base changes from baseline to three months were statistically insignificant (p=0.061; p=0.354; p=0.577). However, CMT (p=0.016) and SRF height (p<0.001) have reduced significantly from baseline to three months. EZ integrity (p=0.009) showed significant changes from baseline to three months. On correlating BCVA changes with OCT parameters, findings were insignificant, but had a negative correlation for CMT (r=-0.030), SRF height (r=-0.083), and SRF base (r=-0.246).

CONCLUSION

Despite insignificant changes in BCVA, SFCT, SRF base, and EZ integrity, eplerenone showed a significant effect in reducing CMT and SRF height, which contributes to minimal improvement in visual acuity.