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SPIRONOLACTONE FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY: A RANDOMIZED CONTROLLED CROSSOVER STUDY.

Bousquet E, Beydoun T, Rothschild PR, Bergin C, Zhao M, Batista R, Brandely ML, Couraud B, Farman N, Gaudric A, Chast F, Behar-Cohen F - Retina (Philadelphia, Pa.) (2015)

Bottom Line: Crossover data analysis showed a statistically significant reduction in SRF in spironolactone treated eyes as compared with the same eyes under placebo (P = 0.04).Secondary analysis on the first period (Day 0-Day 30) showed a significant reduction in subfoveal choroidal thickness in treated eyes as compared with placebo (P = 0.02).In eyes with persistent SRF due to central serous chorioretinopathy, spironolactone significantly reduced both the SRF and the subfoveal choroidal thickness as compared with placebo.

View Article: PubMed Central - PubMed

Affiliation: *Department of Ophthalmology, Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Paris, France, Université Sorbonne Paris Cité; †Inserm U1138, Team 17, Université Sorbonne Paris Cité, Université Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France; ‡Department of Ophthalmology, University of Lausanne, Jules Gonin Ophthalmic Hospital, Fondation Asile des aveugles, Switzerland; §Department of Pharmacy Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Université Sorbonne Paris Cité, Paris, France; ¶INSERM, U1138, Team 1, Université René Descartes Sorbonne Paris Cité, Université Pierre et Marie Curie Paris, Centre de Recherche des Cordeliers, Paris, France; and **Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Université Paris Diderot, Paris, France.

ABSTRACT

Purpose: To evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, for nonresolving central serous chorioretinopathy.

Methods: This is a prospective, randomized, double-blinded, placebo-controlled crossover study. Sixteen eyes of 16 patients with central serous chorioretinopathy and persistent subretinal fluid (SRF) for at least 3 months were enrolled. Patients were randomized to receive either spironolactone 50 mg or placebo once a day for 30 days, followed by a washout period of 1 week and then crossed over to either placebo or spironolactone for another 30 days. The primary outcome measure was the changes from baseline in SRF thickness at the apex of the serous retinal detachment. Secondary outcomes included subfoveal choroidal thickness and the ETDRS best-corrected visual acuity.

Results: The mean duration of central serous chorioretinopathy before enrollment in study eyes was 10 ± 16.9 months. Crossover data analysis showed a statistically significant reduction in SRF in spironolactone treated eyes as compared with the same eyes under placebo (P = 0.04). Secondary analysis on the first period (Day 0-Day 30) showed a significant reduction in subfoveal choroidal thickness in treated eyes as compared with placebo (P = 0.02). No significant changes were observed in the best-corrected visual acuity. There were no complications related to treatment observed.

Conclusion: In eyes with persistent SRF due to central serous chorioretinopathy, spironolactone significantly reduced both the SRF and the subfoveal choroidal thickness as compared with placebo.

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Related in: MedlinePlus

Follow-up of Patient 2, treated with placebo on the first period. She showed a decrease of SRF under placebo at D30 (A and B) and a slight SRF increase after 1 month of spironolactone treatment (C). For each time point, fluorescein angiography images taken at late stage (5 minutes) (left panel) are shown, together with the ETDRS grid (middle panel) and an enhanced depth imaging scan (right panel).
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Figure 6: Follow-up of Patient 2, treated with placebo on the first period. She showed a decrease of SRF under placebo at D30 (A and B) and a slight SRF increase after 1 month of spironolactone treatment (C). For each time point, fluorescein angiography images taken at late stage (5 minutes) (left panel) are shown, together with the ETDRS grid (middle panel) and an enhanced depth imaging scan (right panel).

Mentions: Patient 2 is one of the 3 women of the study, presenting with a long lasting CSC (>1 year) and several RPE leaky points (Figure 6A). She showed minimal improvement under placebo at M1 (Figure 6B) and slight SRF increase after 1 month of spironolactone treatment (Figure 6C). She is representative of absence of response to treatment as observed in another patient of the study.


SPIRONOLACTONE FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY: A RANDOMIZED CONTROLLED CROSSOVER STUDY.

Bousquet E, Beydoun T, Rothschild PR, Bergin C, Zhao M, Batista R, Brandely ML, Couraud B, Farman N, Gaudric A, Chast F, Behar-Cohen F - Retina (Philadelphia, Pa.) (2015)

Follow-up of Patient 2, treated with placebo on the first period. She showed a decrease of SRF under placebo at D30 (A and B) and a slight SRF increase after 1 month of spironolactone treatment (C). For each time point, fluorescein angiography images taken at late stage (5 minutes) (left panel) are shown, together with the ETDRS grid (middle panel) and an enhanced depth imaging scan (right panel).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697359&req=5

Figure 6: Follow-up of Patient 2, treated with placebo on the first period. She showed a decrease of SRF under placebo at D30 (A and B) and a slight SRF increase after 1 month of spironolactone treatment (C). For each time point, fluorescein angiography images taken at late stage (5 minutes) (left panel) are shown, together with the ETDRS grid (middle panel) and an enhanced depth imaging scan (right panel).
Mentions: Patient 2 is one of the 3 women of the study, presenting with a long lasting CSC (>1 year) and several RPE leaky points (Figure 6A). She showed minimal improvement under placebo at M1 (Figure 6B) and slight SRF increase after 1 month of spironolactone treatment (Figure 6C). She is representative of absence of response to treatment as observed in another patient of the study.

Bottom Line: Crossover data analysis showed a statistically significant reduction in SRF in spironolactone treated eyes as compared with the same eyes under placebo (P = 0.04).Secondary analysis on the first period (Day 0-Day 30) showed a significant reduction in subfoveal choroidal thickness in treated eyes as compared with placebo (P = 0.02).In eyes with persistent SRF due to central serous chorioretinopathy, spironolactone significantly reduced both the SRF and the subfoveal choroidal thickness as compared with placebo.

View Article: PubMed Central - PubMed

Affiliation: *Department of Ophthalmology, Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Paris, France, Université Sorbonne Paris Cité; †Inserm U1138, Team 17, Université Sorbonne Paris Cité, Université Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France; ‡Department of Ophthalmology, University of Lausanne, Jules Gonin Ophthalmic Hospital, Fondation Asile des aveugles, Switzerland; §Department of Pharmacy Hôtel-Dieu of Paris, Assistance Publique Hôpitaux de Paris, Université Sorbonne Paris Cité, Paris, France; ¶INSERM, U1138, Team 1, Université René Descartes Sorbonne Paris Cité, Université Pierre et Marie Curie Paris, Centre de Recherche des Cordeliers, Paris, France; and **Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Université Paris Diderot, Paris, France.

ABSTRACT

Purpose: To evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, for nonresolving central serous chorioretinopathy.

Methods: This is a prospective, randomized, double-blinded, placebo-controlled crossover study. Sixteen eyes of 16 patients with central serous chorioretinopathy and persistent subretinal fluid (SRF) for at least 3 months were enrolled. Patients were randomized to receive either spironolactone 50 mg or placebo once a day for 30 days, followed by a washout period of 1 week and then crossed over to either placebo or spironolactone for another 30 days. The primary outcome measure was the changes from baseline in SRF thickness at the apex of the serous retinal detachment. Secondary outcomes included subfoveal choroidal thickness and the ETDRS best-corrected visual acuity.

Results: The mean duration of central serous chorioretinopathy before enrollment in study eyes was 10 ± 16.9 months. Crossover data analysis showed a statistically significant reduction in SRF in spironolactone treated eyes as compared with the same eyes under placebo (P = 0.04). Secondary analysis on the first period (Day 0-Day 30) showed a significant reduction in subfoveal choroidal thickness in treated eyes as compared with placebo (P = 0.02). No significant changes were observed in the best-corrected visual acuity. There were no complications related to treatment observed.

Conclusion: In eyes with persistent SRF due to central serous chorioretinopathy, spironolactone significantly reduced both the SRF and the subfoveal choroidal thickness as compared with placebo.

Show MeSH
Related in: MedlinePlus