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Spironolactone versus observation in the treatment of acute central serous chorioretinopathy
  1. Xinghong Sun1,
  2. Yuanlu Shuai2,
  3. Wangyi Fang3,
  4. Jia Li3,
  5. Weizhong Ge2,
  6. Songtao Yuan3,
  7. Qinghuai Liu3
  1. 1Department of Ophthalmology, Third People’s Hospital of Changzhou, Changzhou, China
  2. 2Department of Ophthalmology, Yixing People’s Hospital, Yixing, China
  3. 3Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  1. Correspondence to Dr Songtao Yuan, Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; yuansongtao{at}vip.sina.com and Weizhong Ge, Department of Ophthalmology, Yixing People’s Hospital, Yixing 214200, China; staff326{at}yxph.com

Abstract

Purpose To evaluate the efficacy of oral spironolactone in patients with acute central serous chorioretinopathy (CSC).

Methods This is a prospective, randomised controlled clinical study. Thirty patients with acute CSC were the participants, including 18 patients who were treated with spironolactone (40 mg orally, twice daily) for 2 months in the experimental group and 12 patients who received observation in the control group. Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid (SRF), changes in central macular thickness (CMT), the height of SRF (SRFH), best corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT). The follow-up period was 2 months.

Results Complete resolution of SRF was achieved in 55.6% (10/18) and 8.3% (1/12) of the eyes in the treatment group and the control group, respectively, at 2 months (p=0.018). The mean CMT and SRFH decreased significantly at each visit in both groups (p<0.05), and there was significant difference between the two groups at 2 months (p<0.05 and p<0.05, respectively). BCVA (in logarithm of the minimum angle of resolution; mean) improved in both groups at 2 months (p<0.05). In the treatment group, the mean baseline SFCT significantly decreased from 502.50±87.38 µm to 427.44±74.37 µm at 2 months (p<0.01), while the change from baseline (from 480.33±102.38 µm to 463.75±100.63 µm) was not significant in the control group (p=0.195). But the differences between the two groups in BCVA and SFCT were not significant.

Conclusions Oral spironolactone is more effective with a faster absorption of SRF than observations. It is a promising treatment for acute CSC.

Trial registration number ChiCTR-IPR-16008428, Results.

  • retina
  • choroid
  • macula
  • treatment medical
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Footnotes

  • SY and WG are co-corresponding authors. SY is responsible for proofs and payment. XS and YS are co-first authors and they contributed equally to this work.

  • Contributors SY was the guarantor of integrity of entire study. YS and WG were involved in study design. XS, YS, WF and JL were involved in data acquisition. WF and JL were involved in statistical analysis. XS and YS were involved in manuscript preparation. SY and WG were involved in manuscript revision/review. SY was involved in the approval of the manuscript’s final version.

  • Funding This research was supported by Jiangsu natural science fund projects BK20151586

  • Competing interests None declared.

  • Ethics approval The study was approved by the Ethics Committee of The First Affiliated Hospital of Nanjing Medical University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it was published Online First. A statement about co-first authors has been added in.

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