ROLE OF ORAL EPLERENONE IN THE MANAGMENT OF CENTRAL SEROUS CHORIORETINOPATHY

Abstract

Background: Central serous chorioretinopathy (CSCR) is a retinal disorder characterized by serous detachment of the neurosensory retina due to choroidal hyperpermeability and dysfunction of the retinal pigment epithelium. It predominantly affects middle-aged individuals and can lead to significant visual disturbances. Although often self-limiting, persistent cases necessitate therapeutic intervention. Mineralocorticoid receptor antagonists such as Eplerenone have emerged as potential treatment options. This study was conducted to evaluate the efficacy of Eplerenone compared to observation alone in patients with CSCR.

Objective: To compare the efficacy of oral Eplerenone (25 mg once daily) with observation alone in patients diagnosed with central serous chorioretinopathy.

Methods: This quasi-experimental study was conducted at the Armed Forces Institute of Ophthalmology, Rawalpindi, from January 2023 to April 2023. Sixty patients were enrolled and divided equally into two groups: Group A received oral Eplerenone 25 mg once daily, while Group B was observed without treatment. Patients were evaluated at 4, 8, and 12 weeks for best corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography. Data were analyzed using SPSS version 23, and an independent sample t-test was applied, with a p-value of <0.05 considered statistically significant.

Results: The study population comprised 41 males (68.33%) and 19 females (31.67%). The mean baseline CMT in Group A was 438.90 (±84.06) µm, reducing to 360.90 (±82.49) µm at 12 weeks, whereas in Group B, baseline CMT was 420.27 (±58.19) µm, decreasing to 316.27 (±73.03) µm. A statistically significant difference in CMT reduction between the two groups was observed at 12 weeks (p=0.03). However, the difference in BCVA improvement between groups was not statistically significant (p=0.26).

Conclusion: Oral Eplerenone showed superior anatomical outcomes by achieving a quicker and greater reduction in central macular thickness compared to observation alone, though functional visual gains did not significantly differ between groups. Eplerenone appears to offer a beneficial option for anatomical improvement in CSCR management.