Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice

Suthasinee Sinawat,1 Watcharaporn Thongmee,1 Thuss Sanguansak,1 Wipada Laovirojjanakul,1 Supat Sinawat,2 Yosanan Yospaiboon1 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen Univers...

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Autores principales:	Sinawat S, Thongmee W, Sanguansak T, Laovirojjanakul W, Yospaiboon Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	spironolactone chronic non-resolving persistent central serous chorioretinopathy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a84feb2232264a348fe09ff96e9078f4
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spelling	oai:doaj.org-article:a84feb2232264a348fe09ff96e9078f42021-12-02T11:37:04ZOral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice1177-5483https://doaj.org/article/a84feb2232264a348fe09ff96e9078f42020-06-01T00:00:00Zhttps://www.dovepress.com/oral-spironolactone-versus-conservative-treatment-for-non-resolving-ce-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Suthasinee Sinawat,1 Watcharaporn Thongmee,1 Thuss Sanguansak,1 Wipada Laovirojjanakul,1 Supat Sinawat,2 Yosanan Yospaiboon1 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Yosanan Yospaiboon; Suthasinee SinawatKKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Highway, Khon Kaen 40002, ThailandTel +66 43 348383Email yyosanan@gmail.com; ssuthasinee@kku.ac.thObjective: To compare the efficacy of oral spironolactone treatment versus conservative treatment for patients with persistent central serous chorioretinopathy (CSC) in real-life practice.Design: Retrospective comparative study.Patients and Methods: Medical records and retinal images of 62 patients with non-resolving CSC were reviewed. Twenty-one patients received oral spironolactone (50 mg/day) while 41 patients received conservative treatment. Primary outcome was proportion of eyes with complete resolution of subretinal fluid (SRF) within 6 months. Secondary outcome measures included changes in SRF height, central macular thickness (CMT), lesion size and best-corrected visual acuity (BCVA). The occurrence of drug side effect was also assessed.Results: There was no significant difference in demographic data, clinical characteristics, optical coherence tomography parameters and leaking patterns in fluorescein fundus angiography between two groups. Complete resolution of SRF was significantly higher and faster in the spironolactone group than the conservative treatment group (p=0.03). Although significant anatomical improvement in SRF height, CMT and lesion size were observed in both groups (p < 0.001), final BCVA was improved significantly in only the spironolactone group (p < 0.05). The recurrence of SRF after complete resolution was observed in 4/12 eyes (33.33%) in the treatment group. None of the patients experienced any side effects of spironolactone.Conclusion: Oral spironolactone (50 mg/day) could achieve both significant anatomical and visual improvement, while the significant visual gain could not be provided with the conservative treatment. Spironolactone should be considered as an alternative treatment option in non-resolving CSC patients who cannot afford the PDT treatment.Keywords: spironolactone, chronic, non-resolving, persistent, central serous chorioretinopathySinawat SThongmee WSanguansak TLaovirojjanakul WSinawat SYospaiboon YDove Medical Pressarticlespironolactonechronicnon-resolvingpersistentcentral serous chorioretinopathyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1725-1734 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	spironolactone chronic non-resolving persistent central serous chorioretinopathy Ophthalmology RE1-994
spellingShingle	spironolactone chronic non-resolving persistent central serous chorioretinopathy Ophthalmology RE1-994 Sinawat S Thongmee W Sanguansak T Laovirojjanakul W Sinawat S Yospaiboon Y Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
description	Suthasinee Sinawat,1 Watcharaporn Thongmee,1 Thuss Sanguansak,1 Wipada Laovirojjanakul,1 Supat Sinawat,2 Yosanan Yospaiboon1 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Yosanan Yospaiboon; Suthasinee SinawatKKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Highway, Khon Kaen 40002, ThailandTel +66 43 348383Email yyosanan@gmail.com; ssuthasinee@kku.ac.thObjective: To compare the efficacy of oral spironolactone treatment versus conservative treatment for patients with persistent central serous chorioretinopathy (CSC) in real-life practice.Design: Retrospective comparative study.Patients and Methods: Medical records and retinal images of 62 patients with non-resolving CSC were reviewed. Twenty-one patients received oral spironolactone (50 mg/day) while 41 patients received conservative treatment. Primary outcome was proportion of eyes with complete resolution of subretinal fluid (SRF) within 6 months. Secondary outcome measures included changes in SRF height, central macular thickness (CMT), lesion size and best-corrected visual acuity (BCVA). The occurrence of drug side effect was also assessed.Results: There was no significant difference in demographic data, clinical characteristics, optical coherence tomography parameters and leaking patterns in fluorescein fundus angiography between two groups. Complete resolution of SRF was significantly higher and faster in the spironolactone group than the conservative treatment group (p=0.03). Although significant anatomical improvement in SRF height, CMT and lesion size were observed in both groups (p < 0.001), final BCVA was improved significantly in only the spironolactone group (p < 0.05). The recurrence of SRF after complete resolution was observed in 4/12 eyes (33.33%) in the treatment group. None of the patients experienced any side effects of spironolactone.Conclusion: Oral spironolactone (50 mg/day) could achieve both significant anatomical and visual improvement, while the significant visual gain could not be provided with the conservative treatment. Spironolactone should be considered as an alternative treatment option in non-resolving CSC patients who cannot afford the PDT treatment.Keywords: spironolactone, chronic, non-resolving, persistent, central serous chorioretinopathy
format	article
author	Sinawat S Thongmee W Sanguansak T Laovirojjanakul W Sinawat S Yospaiboon Y
author_facet	Sinawat S Thongmee W Sanguansak T Laovirojjanakul W Sinawat S Yospaiboon Y
author_sort	Sinawat S
title	Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
title_short	Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
title_full	Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
title_fullStr	Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
title_full_unstemmed	Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice
title_sort	oral spironolactone versus conservative treatment for non-resolving central serous chorioretinopathy in real-life practice
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/a84feb2232264a348fe09ff96e9078f4
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Oral Spironolactone versus Conservative Treatment for Non-Resolving Central Serous Chorioretinopathy in Real-Life Practice

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