Investigating the efficacy and safety of oral spironolactone in patients with central serous chorioretinopathy

Summary Objective The goal of this study was to investigate the efficacy and safety of oral spironolactone in patients with central serous chorioretinopathy (CSC). Materials and methods In our study, acute CSC patients were divided into two groups: those who received spironolactone 25 mg twice a day as the study group, and those who were not treated as the control group. Fundus fluorescein angiography was performed in all patients. Subretinal fluid (SRF) height and central macular thickness (CMT) spectral area were measured by optical coherence tomography as well as subfoveal choroid thickness (CT) in enhanced depth imaging (EDI) mode. The best-corrected visual acuity (BVCA) was measured with the Snellen chart. Side effects of spironolactone were evaluated. Results There were 31 eyes in the study group and 28 eyes in the control group. The mean follow-up was 2.4 ± 0.5 months. The average SRF height of 240.26 ± 92.89 μm in the study group decreased to 26.77 ± 39.52 μm (P   0.05) at the last follow-up. SRF height was completely improved in 18 eyes (58.06%). On the first evaluation, the mean CMT of 453.26 ± 147.73 was reduced to 276.19 ± 109.29 μm at the last follow-up. (P   0.05). While the initial mean subfoveal CT was 482.10 ± 86.36 μm, it decreased to 427.10 ± 83.32 μm at the last follow-up (P   0.01). The mean baseline BCVA of 0.5 ± 0.23 was increased to 0.9 ± 0.16 (P   0.01) at the last follow-up. At the last follow-up, BCVA was 10/10 (1.0) in 21 eyes (67.74%). In the control group, the mean SRF height of 277.71 ± 108.83 μm was 172.96 ± 93.88 μm (P   0.05) at the last follow-up. The mean CMT in the control group was 464.5 ± 131.14 μm at the first evaluation and 349.82 ± 111.45 μm (P   0.05) at the last follow-up. The initial mean subfoveal CT was 487.93 ± 88.9 μm; at the last follow-up, it was 447.71 ± 71.32 μm (P   0.01). While the mean BCVA of the control group was initially 0.53 ± 0.19, it was found to be 0.64 ± 0.19 (P   0.01) at the final control. The decrease in SRF height in the 3rd month was significantly greater in the study group compared to the control group (P   0.01). However, the decrease in CMT at 3 months and an increase in BCVA were also significant in the study group compared to the control group (P   0.01). CT decreased significantly in the third month in both groups compared to the first month, but there was no difference between the two groups. In a patient who developed palpitations and nausea, treatment was discontinued because he could not tolerate oral spironolactone. Conclusion In our series, effective visual improvement and subretinal fluid resorption were achieved in acute CSC patients who were given spironolactone. Side effects are rare.