Oral Eplerenone for Central Serous Chorioretinopathy: A Randomized Controlled Trial

Purpose: Our study aimed to investigate the effectiveness of eplerenone in enhancing visual and anatomical recovery in patients diagnosed with Central Serous Chorioretinopathy (CSCR). Methods: A prospective randomized controlled trial was conducted between November 2022 and April 2023 on patients diagnosed with CSCR. Patients were randomly allocated into two groups: group 1 received oral eplerenone 50 mg twice daily in addition to standard therapy (topical nonsteroidal anti-inflammatory drugs, oral multivitamins), while group 2 received standard therapy alone. Patients were evaluated for best-corrected visual acuity (BCVA), neurosensory detachment (NSD), and choroidal thickness (CT) at baseline and after 90 days of treatment. Results: Eighty-three patients were enrolled in the study (group 1: 43; group 2: 40). Both groups demonstrated significant improvement from baseline to day 90 in BCVA (group 1: logMAR 0.57 ± 0.34 to 0.12 ± 0.24; group 2: 0.60 ± 0.64 to 0.17 ± 0.15; P < 0.01 for both), reduction in NSD (group 1: 315 ± 144.93 to 5.76 ± 12.03 μm; group 2: 284.23 ± 175.39 to 13 ± 14.7 μm; P < 0.01 for both), and CT (group 1: 340.25 ± 32.77 to 264.18 ±31.71 μm; group 2: 332.28 ± 49.93 to 266.2 ± 23.92 μm; P < 0.01 for both). No significant differences were noted between the groups in the measured parameters at baseline. At day 90, NSD was significantly lower in group 1 compared to group 2 ( P < 0.01). Group 1 also showed better BCVA ( P = 0.31) and lower CT ( P = 0.89) compared to group 2. Conclusion: Our study demonstrates that eplerenone enhances visual and anatomical recovery compared to standard therapy alone. However, further prospective studies are required to establish definitive evidence.