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Subthreshold laser compared to oral spironolactone for the treatment of chronic central serous chorioretinopathy: a retrospective study

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Abstract

Purpose

To compare functional and morphological outcomes of Subthreshold Laser (STL) and Oral Spironolactone (SPR) in treating chronic central serous chorioretinopathy (CSCR).

Methods

This is a retrospective observational study. Treatment-naïve patients with chronic CSCR treated with STL or SPR were included, and data was reviewed at baseline, 1, 3, 6 and 12-month follow-up. Main outcome measures were changes in Central Macular Thickness (CMT) and Subretinal Fluid (SRF) height, and complete resolutions of SRF. Sub-analysis based on retinal pigmented epithelium (RPE) status at baseline was performed.

Results

47 and 47 patients received STL and SPR, respectively. At all timepoints, both treatments significantly improved CMT and SRF (p < 0.05). No significant changes in best corrected visual acuity (BCVA) were recorded and no significant differences between treatment groups were present at each corresponding follow-up. Complete resolution of SRF was achieved in 29% and 36% of patients treated with STL or SPR, respectively, at 12-months follow up.

Eyes treated with STL and intact RPE showed significant SRF decrease at 6 months and significantly better BCVA at 1, 3 and 6 months compared to eyes with disrupted RPE layer (p < 0.05). In both treatment groups, intact RPE was associated with a higher rate of complete SRF resolutions, with 43% vs 13% in the STL group and 50% vs 26% in the SPR group.

Conclusion

STL and SPR are effective treatments for chronic CSCR. Greater resolution of subretinal fluid was observed in eyes with intact RPE, hence both treatments should be initiated in the earlier stages of the disease.

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Authors and Affiliations

  1. Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Rd, London, NW1 5QH, UK

    Stefano Mercuri, Francesco Maria D’Alterio, Walid Raslan, Atul Gupta, Nancy Khairat, Paolo Corazza & Saad Younis

  2. Mid and South Essex NHS Foundation Trust, Southend, UK

    Beatrice Gallo

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  1. Stefano Mercuri
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Contributions

SM, FD, BG, PC and SY conceptualized and designed the study; WR, AG and NK collected the data; SM analyzed the data; SM and FD prepared the tables and figures; all Authors contributed to the drafting and revision of the manuscript manuscript.

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Correspondence to Stefano Mercuri.

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Mercuri, S., D’Alterio, F.M., Gallo, B. et al. Subthreshold laser compared to oral spironolactone for the treatment of chronic central serous chorioretinopathy: a retrospective study. Int Ophthalmol 44, 131 (2024). https://doi.org/10.1007/s10792-024-03063-3

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