Vol. 3, Issue 1, Part A (2021)

Background: Chronic central serous chorioretinopathy (CSCR) is a vision-threatening disease characterized by serous subretinal fluid (SRF) accumulation causing a localized area of retinal detachment. The outer retinal barrier disruption leads to the accumulation of SRF. CSCR affects about 1 in 10,000 people, with men affected more commonly than women. Objective: To evaluate the mineralocorticoid receptor antagonist in reducing subretinal fluid measurements as well as reduced central Subfoveal thickness along with improved visual acuity. As a treatment option for patients with CSCR, mineral corticosteroid receptor antagonist drugs such as oral eplerenone have been considered. Methods: This prospective interventional study was conducted in Ispahani Islamia Eye Institute & Hospital, Dhaka, Bangladesh from September 2015 to February 2016. A total of 30 OPD patients was recruited as the study population. All 30 patients with central serous chorioretinopathy were reviewed and treated with mineralocorticoid antagonists. Results: Out of a total of 30 patients, the average age of patients was 35.5 years. The average duration of mineralocorticoid antagonist treatment was 3.9±2.1 months. Sixteen patients (53.33%) showed decreased CMT & MV, eight patients (26.67%) had an increase in both, and six patients (20%) had negligible changes. The mean decrease in CMT of all patients was 42.4 µm, ref range, 136 to 255 µm. The mean decrease in MV of all patients was 0.20 mm3 (range, 2.33 to 2.90 mm3). Median visual acuity at the start of therapy was 20/30 (range, 20/20 to 20/250). And at final follow-up, it was 20/40 (range, 20/20 to 20/125). Conclusion: In half of our patient’s mineralocorticoid antagonist treatment had a positive treatment effect. In eplerenone oral therapy, there was a significant reduction in the subretinal fluid in eyes with chronic CSCR. Additionally, a reduction in central macular thickness & central macular volume is noted with improved visual acuity. Further research including larger prospective randomized trials is needed to validate these findings.