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Efficacy of eplerenone in therapy-resistant chronic CSC

Session Details

Session Title: Quick Fire Free Paper Session 04

Session Date/Time: Sunday 29/09/2013 | 11:00-13:00

Paper Time: 11:25

Venue: Hall C (Level 1)

First Author: C.Boon THE NETHERLANDS

Co Author(s):    M. Breukink   A. den Hollander   A. Ossewaarde-van Norel   J. Keunen     

Abstract Details

"Purpose:

To describe the safety and efficacy of treatment with oral eplerenone, a selective aldosterone-antagonist, in patients with chronic central serous chorioretinopathy (CSC) who were previously unresponsive to alternative treatments.

Setting:

Retrospective case series study in a tertiary referral centre.

Methods:

Five patients with previous unsuccessful treatment(s) for active chronic CSC were treated with eplerenone for a period of 5 weeks. Best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (OCT), fundus autofluorescence, fluorescein and indocyanine green angiography (FA and ICGA), as well as systemic parameters, were evaluated over a follow-up period of 10 weeks.

Results:

One patient (20%) responded with an absence of subretinal fluid (SRF) on OCT, which remained stable until the final follow-up. One patient initially had a decrease of SRF but then relapsed after cessation of the eplerenone treatment, resulting in an increase of SRF. In two patients SRF was not affected by therapy. In the last patient, suffering from bilateral disease, one eye first had a decrease of SRF which then returned to baseline-level and in the other eye an increase of SRF was seen. BCVA increased slightly in two patients. Enhanced depth OCT did not show changes in choroidal thickness during the study in any of the patients. Eplerenone had also no effect on hot-spots seen on FA and ICGA. Besides minor complains of fatigue in two patients, no side-effects were identified.

Conclusions:

This pilot study in previously therapy-resistant patients suffering from chronic CSC shows that eplerenone is a well tolerated drug but was unable to confirm a convincing positive effect in these patients."

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