Therapeutic Effects and Safety of Spironolactone for Central Serous Chorioretinopathy

Purpose To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy (CSC). Methods Medical records and imaging data from consecutive patients diagnosed with CSC and treated with SPRL were reviewed. Changes in central macular thickness (CMT), subretinal fluids (SRF), subfoveal choroidal thickness (SFCT), and best corrected visual acuity (BCVA) were measured at baseline and follow-up visits. Follow-up visits were performed at 1, 3, 6, and 12 months after treatment. The patients were divided into two groups; acute and chronic, and the therapeutic outcomes were compared. The occurrence of side effects and recurrence after complete resolution of SRF were also assessed. Results A total of 42 patients with 45 eyes were included. CMT and SRF after using SPRL improved significantly at 1, 3, 6, and 12 months and SFCT improved at 3, 6, and 12 months. However, BCVA showed no significant change at any time. Acute patients showed similar results. However, in chronic patients, CMT showed significant differences at 1 and 3 months, SRF at 1 and 6 months, and SFCT at 6 months. A total of 15.6%, 38.2%, 45.8%, and 50.0% of eyes showed complete resolution of SRF at each follow-up period, respectively, and 8.9% of eyes showed recurrence after complete resolution. Two male patients experienced gynecomastia and one patient showed mild elevation of serum creatinine. Conclusions Our study supported the therapeutic benefits of SPRL in patients with CSC, especially in anatomical structures. However, careful observation is required because of side effects and recurrence after complete resolution.ope