Micropulse Laser versus Eplerenone for Chronic Central Serous Chorioretinopathy: A 12-Month Comparison

• Published in: Ophthalmology and Therapy
• Main Authors: Pasquale Viggiano, Giacomo Boscia, Enrico Borrelli, Federica Evangelista, Ermete Giancipoli, Rodolfo Mastropasqua, Alberto Quarta, Maria Oliva Grassi, Raffaella Aloia, Giovanni Alessio, Lisa Toto, Francesco Boscia
• Format: Article
• Language: English
• Published: Adis, Springer Healthcare 2024-10-01
• Subjects: Optical coherence tomography; OCT; Central serous chorioretinopathy; Pachychoroid; Subfoveal choroidal thickness
• Online Access: https://doi.org/10.1007/s40123-024-01059-x
• ISSN: 2193-8245; 2193-6528

Abstract Introduction To compare the long-term efficacy of navigated subthreshold micropulse laser (NSML) and continuous oral eplerenone (EPL) in chronic central serous chorioretinopathy (cCSC). Methods This retrospective observational study included 44 eyes with cCSC (EPL: n = 26; NSML: n = 18). Best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT) were evaluated over 12 months. Results Both groups showed significant improvements in BCVA and CMT (p < 0.05). Complete SRF resolution was achieved in both groups by 12 months, with NSML showing faster resolution (2.77 ± 1.43 vs. 6.34 ± 2.17 months, p < 0.001). The EPL group demonstrated significant SFCT reduction at 6 and 12 months (p = 0.001), while the NSML group showed no significant SFCT changes (p > 0.05). Conclusions Both NSML and EPL improved retinal morphology and visual function in patients with cCSC. NSML achieved faster SRF resolution, while EPL resulted in more significant choroidal thickness reduction. These findings suggest distinct mechanisms of action: NSML primarily affects the retinal pigment epithelium, while EPL modulates choroidal vasculature. Treatment choice may depend on individual patient characteristics and treatment goals.