Oral eplerenone in first-episode acute central serous chorioretinopathy: results of a double-masked randomized trial.
Ghodsieh Zamani, Roozbeh Asghari, Nasser Shoeibi et al.
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In 30 seconds
This double-masked, randomized, placebo-controlled trial evaluated oral eplerenone in 44 patients with first-episode acute central serous chorioretinopathy (CSCR). Participants received eplerenone 25 mg twice daily or placebo for three months. Both groups had reductions in central macular thickness and subretinal fluid, but subretinal fluid absorption was significantly greater with eplerenone at three months (P < 0.05). Choriocapillaris vessel density and flow index also improved significantly with eplerenone (P < 0.001), whereas visual acuity improved similarly in both groups.
Key findings
- At three months, subretinal fluid absorption was significantly greater with eplerenone than placebo (P < 0.05).
- Choriocapillaris vessel density and flow index improved significantly with eplerenone (P < 0.001).
- Best-corrected visual acuity improved similarly in the eplerenone and placebo groups.
- Superficial, deep, and radial peripapillary plexus densities did not differ between groups.
Why it matters
The trial suggests that eplerenone may improve anatomical resolution of subretinal fluid and choriocapillaris perfusion in acute CSCR, without a corresponding advantage in visual acuity over the study period. These findings distinguish structural and microvascular changes from functional outcomes and may inform interpretation of treatment effects in this condition.
What to keep in mind
The trial included 44 patients and followed outcomes for three months; the abstract does not report longer-term outcomes.