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Herold, Tina Rike; Rist, Kristina; Priglinger, Siegfried Georg; Ulbig, Michael Werner; Wolf, Armin (2017): Long-term results and recurrence rates after spironolactone treatment in non-resolving central serous chorio-retinopathy (CSCR). In: Graefes Archive for Clinical and Experimental Ophthalmology, Vol. 255, No. 2: pp. 221-229
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Abstract

To evaluate the long-term results of spironolactone in non-resolving central serous chorio-retinopathy (CSCR) and recurrence rates of CSCR. Interventional uncontrolled open-label prospective clinical trial of patients with non-resolving CSCR who were treated with spironolactone 50 mg daily (Spironolacton ALA (R) 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 mu m 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. 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 mu m +/- 131 SD) to visit 12 (53 mu m +/- 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. 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.