Abstract
Background Chorioretinopathy centralis serosa (CCS) is a common disease that leads to the loss
of retinal ion/fluid homeostasis due to decompensation of the retinal pigment epithelium,
resulting in fluid accumulation with detachment of the neurosensory retina and/or
retinal pigment epithelium. We investigated the effect of eplerenone, a mineralocorticoid
receptor inhibitor, on chronic recurrent CCS (cr-CCS).
Methods A retrospective study with data analysis of 17 eyes (12 patients) between 2014 – 2021
with cr-CCS in whom other methods were not effective, not applicable, or not desired,
was performed. Duration of CCS was at least 12 months with at least one recurrence.
Each patient received 25 mg (1st week) and 50 mg (from the 2nd week) for at least
3 months. In each case, best-corrected visual acuity and central and peripheral retinal
thickness were measured by spectral-domain optical coherence tomography. Side effects
were rated by the patients as “none”, “mild” (noticeable but not affecting), “tolerable”
(affecting but acceptable because of good effect), and “not tolerable” (then discontinuation
of therapy).
Results There was no significant reduction in central or peripheral retinal thickness. A
complete reduction of subretinal fluid was achieved in 5 of 17 eyes (29.4%). In 12
eyes, no effect of eplerenone could be detected, so other therapies were required.
Visual acuity change was mainly dependent on the duration of CCS and the degree of
photoreceptor damage. Side effects were reported by 11 patients as “none” and 1 patient
as “mild” (arterial hypotension). No other side effects were observed.
Conclusion The response rates of therapy with eplerenone were relatively low, and no significant
effect could be demonstrated. Eplerenone should not (no longer) be routinely used
in the therapy of cr-CCS.
Key words
central serous chorioretinopathy - eplerenone - mineralocorticoid receptor antagonist
