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Long-term results and recurrence rates after spironolactone treatment in non-resolving central serous chorio-retinopathy (CSCR)

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the long-term results of spironolactone in non-resolving central serous chorio-retinopathy (CSCR) and recurrence rates of CSCR.

Methods

Interventional uncontrolled open-label prospective clinical trial of patients with non-resolving CSCR who were treated with spironolactone 50 mg daily (Spironolacton AL® 50 mg, ALIUD PHARMA) for up to 16 weeks. Follow-up visits were performed at 3, 6, 9, and 12 months. Retreatment criteria for recurrence were: gain in sub-retinal fluid (SRF) of more than 25 % plus/or increase of central retinal thickness (CRT) of more than 50 μm plus visual symptoms compared to last visit. Main outcome measures: 12-month efficacy of upload treatment with spironolactone. Secondary outcome measure was the recurrence rate at 6, 9, and 12 months.

Results

Of the 21 study eyes treated, 71 % (n = 15) showed significant improvement or complete regression on OCT examination over 12 months. Nineteen percent of the patients (n = 4) showed a stable course from visit 1 to visit 12. The overall reduction of sub-retinal fluid from visit 1 (156 μm ± 131 SD) to visit 12 (53 μm ± 93 SD) was statistically significant (p = 0.003). The change of mean visual acuity (log MAR) from 0.25 (± 0.17 SD) at baseline to 0.17 (± 0.18 SD) at visit 12 was statistically significant, with p = 0.044.

Conclusion

Our results confirm a positive effect of spironolactone in non-resolving CSCR in 71 % of cases. Evaluation of recurrence rates and retreatments showed good results in patients who responded to spironolactone primarily.

A prospective randomized trial may provide better data about this non-invasive treatment.

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Acknowledgments

The authors thank Dr. Markus Schaumberger (University Eye Hospital – LMU, Department of Ophthalmology, Mathildenstrasse 8, D-80336 Munich, Germany) for his critical work and statistical analysis of the study

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Authors and Affiliations

  1. University Eye Hospital – LMU, 80539, Munich, Germany

    Tina Rike Herold, Kristina Rist, Siegfried Georg Priglinger & Armin Wolf

  2. Department of Ophthalmology, Ludwig-Maximilians Universität, 80539, Munich, Germany

    Tina Rike Herold, Kristina Rist, Siegfried Georg Priglinger & Armin Wolf

  3. Klinikum der Universität München, Campus Innenstadt, Mathildenstrasse 8, D-80336, Munich, Germany

    Tina Rike Herold, Kristina Rist, Siegfried Georg Priglinger & Armin Wolf

  4. Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675, Munich, Germany

    Michael Werner Ulbig

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  1. Tina Rike Herold
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Correspondence to Tina Rike Herold.

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No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Herold, T.R., Rist, K., Priglinger, S.G. et al. Long-term results and recurrence rates after spironolactone treatment in non-resolving central serous chorio-retinopathy (CSCR). Graefes Arch Clin Exp Ophthalmol 255, 221–229 (2017). https://doi.org/10.1007/s00417-016-3436-5

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  • DOI: https://doi.org/10.1007/s00417-016-3436-5

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