Oral eplerenone in first-episode acute central serous chorioretinopathy: results of a double-masked randomized trial.

IF 1.7 4区医学 Q3 OPHTHALMOLOGY

International Ophthalmology Pub Date : 2026-10-12 DOI:10.1007/s10792-026-04287-1

Ghodsieh Zamani, Roozbeh Asghari, Nasser Shoeibi, Majid Abrishami, Seyedeh Maryam Hoseini, Mohammad-Reza Ansari-Astaneh, Mojtaba Abrishami, Elham Bakhtiari, Mehrdad Motamed Shariati

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引用次数: 0

Abstract

Background: Central serous chorioretinopathy (CSCR) is a pachychoroid disorder characterized by serous retinal detachment driven by choroidal vascular dysfunction and mineralocorticoid receptor (MR) overactivation. Eplerenone, a selective MR antagonist, has been proposed as a therapeutic option, although clinical evidence remains inconsistent.

Methods: In a randomized, double-blind, placebo-controlled trial, 44 patients with first-episode acute CSCR received either oral eplerenone (25 mg twice daily) or placebo for three months. Outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (CT), and OCT-angiography parameters of retinal and choroidal microvasculature.

Results: Both groups demonstrated significant reductions in CMT and SRF over time, but SRF absorption was significantly greater in the eplerenone group at 3 months (P < 0.05). Choriocapillaris vessel density and flow index improved significantly with eplerenone (P < 0.001), while superficial, deep, and radial peripapillary plexus densities did not differ between groups. BCVA improved similarly in both groups.

Conclusion: Eplerenone accelerates SRF resolution and enhances choriocapillaris perfusion in acute CSCR, although visual outcomes remain comparable to placebo. Early MR antagonism may offer anatomical and microvascular benefits in CSCR management.

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口服依普莱酮治疗首发急性中枢性浆液性脉络膜视网膜病变：一项双盲随机试验的结果。

背景：中枢性浆液性脉络膜视网膜病变（CSCR）是一种以脉络膜血管功能障碍和矿皮质激素受体（MR）过度激活驱动的浆液性视网膜脱离为特征的厚脉络膜疾病。选择性MR拮抗剂Eplerenone已被提议作为一种治疗选择，尽管临床证据仍不一致。方法：在一项随机、双盲、安慰剂对照试验中，44例首发急性CSCR患者接受口服依普利酮（25 mg，每日2次）或安慰剂治疗3个月。结果包括最佳矫正视力（BCVA）、黄斑中央厚度（CMT）、视网膜下液（SRF）高度、中央凹下脉络膜厚度（CT）、视网膜和脉络膜微血管oct血管造影参数。结果：两组CMT和SRF随时间的推移均显著降低，但3个月时依普利酮组SRF吸收显著增加（P < 0.05）。eplerenone组绒毛毛细血管密度和血流指数显著改善（P < 0.001），而浅表、深层和径向乳头周围丛密度组间无差异。两组的BCVA改善相似。结论：依普利酮可加速急性CSCR患者的SRF消退并增强绒毛膜毛细血管灌注，但视觉效果仍与安慰剂相当。早期MR拮抗剂可能在CSCR治疗中提供解剖学和微血管方面的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

451

期刊介绍： International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.