Oral spironolactone treatment in chronic central serous chorioretinopathy

Purpose: To evaluate the effect of oral spironolactone for non-resolving chronic central serous chorioretinopathy after intravitreal bevacizumab injection. Methods: Seventeen eyes of 17 patients with non-resolving chronic central serous chorioretinopathy after intravitreal bevacizumab injection from September 2017 to December 2018 were treated with oral spironolactone for 6 months, and changes in central macular thickness, subretinal fluid height, and best-corrected visual acuity (BCVA) were analyzed retrospectively. Results: The central macular thickness decreased from 309.94 ± 105.20 µm at baseline to 259.76 ± 81.83 µm at 3 months, and 243.11 ± 61.98 µm at 6 months, which were both statistically significant (Wilcoxon signed-rank test, p = 0.016 and p = 0.001, respectively). The subretinal fluid height decreased from 138.05 ± 95.69 µm at baseline to 70.88 ± 83.13 µm at 3 months, and 54.00 ± 56.25 µm at 6 months, which were both statistically significant (Wilcoxon signed-rank test, p = 0.002 and p = 0.000, respectively). The BCVA (LogMAR) changed from 0.30 ± 0.38 at baseline to 0.35 ± 0.43 at 1 month, 0.29 ± 0.43 at 3 months, and 0.26 ± 0.40 at 6 months. The results at 6 months were statistically significant (Wilcoxon signed-rank test, p = 0.033). There were no side effects in patients treated with oral spironolactone. Conclusions: In chronic central serous chorioretinopathy, treatment with oral spironolactone significantly reduced the central macular thickness, subretinal fluid height, and the BCVA, without side effects.