Topical Dexamethasone as an Adjuvant to Mineralocorticoid Receptor Antagonists for the Treatment of Recalcitrant Central Serous Chorioretinopathy

• Published in: Ophthalmic surgery, lasers & imaging Vol. 53; no. 12; pp. 659 - 665
• Main Authors: Wong, Amanda, Zhu, Daniel, Li, Albert S, Lee, Jessica G, Ferrone, Philip J
• Format: Journal Article
• Language: English
• Published: United States Slack, Inc 01.12.2022; SLACK INCORPORATED
• Subjects: Central nervous system depressants; Central Serous Chorioretinopathy - diagnosis; Central Serous Chorioretinopathy - drug therapy; Chronic Disease; Dexamethasone; Diabetic retinopathy; Edema; Eplerenone; Eye (anatomy); Fluorescein Angiography; Humans; Hypotheses; Medical research; Medicine, Experimental; Mineralocorticoid Receptor Antagonists - therapeutic use; Patients; Photodynamic therapy; Pilot Projects; Retina; Retrospective Studies; Steroids; Thickness; Tomography, Optical Coherence; Vascular endothelial growth factor; Visual acuity; New York
• ISSN: 2325-8160; 2325-8179
• DOI: 10.3928/23258160-20221115-02

A previous report demonstrated efficacy of mineralocorticoid antagonist with adjuvant topical dexamethasone (MRA+DEX) in resolving subretinal fluid (SRF) in a chronic central serous chorioretinopathy (CSCR) patient. This pilot study investigates the use of MRA+DEX to treat recalcitrant, chronic CSCR patients. Retrospective review of chronic, recalcitrant CSCR patients unresponsive to MRA alone who were treated with MRA+DEX and followed for up to 3 months. Apical SRF thickness and visual acuity were measured. Ten eyes of eight chronic, recalcitrant patients were included with an average follow-up of 109 days. Mean percent reduction in apical fluid thickness at one month and at last follow-up after adding dexamethasone (DEX) was 33% and 52%, respectively. Five eyes (50%) achieved complete resolution of SRF. Three eyes (30%) showed partial response and two (20%) eyes had no response. There was no significant change in visual acuity. MRA+DEX decreased SRF in some recalcitrant, chronic CSCR patients. Large prospective studies are needed to evaluate the utility of MRA+DEX in these chronic CSCR patients. .