The relation of the serum aldosterone level and central serous chorioretinopathy – a pilot study

OBJECTIVE: The aim of this study was to investigate the serum aldosterone level and abnormal levels of mineral corticoid in patients with the central serous chorioretinopathy (CSC).

PATIENTS AND METHODS: All recruited patients with CSC received fundus fluorescein angiography (FFA), enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and serum aldosterone assay. The patients were classified into spontaneously resolved group and unresolved group according to a 3-months follow-up of Optical Coherence Tomography (OCT) examination. Patients from unresolved group were recruited to receive treatment with 40 mg spironolactone orally for 2 months. After the treatment, the EDI-OCT and best corrected visual acuity (BCVA) were performed again to assess the treatment efficacy.

RESULTS: The study included 61 patients (72 eyes) with 34 patients in the unresolved group and 27 patients in the resolved group. The aldosterone level was significantly associated with the subfoveal choroidal thickness (SFCT) of revolved CSC eyes (r=0.342, p<0.05) as well as the SFCT of unresolved CSC eyes (r=0.348, p<0.05). And the aldosterone level in the unresolved CSC group was greater than that in the spontaneously resolved group (161.8 ± 50.1 ng/dl vs. 122.5 ± 50.5 ng/dl, p<0.05). The central macular thickness and SFCT were decreased significantly (p<0.05) after the treatment with 40 mg/d spironolactone for two months.

CONCLUSIONS: The unresolved CSC patients were characterized by high level of aldosterone and thickened SFCT. Spironolactone treatment was associated with the improvement of chronic CSC. Besides, the side effect of spironolactone treatment was rare.

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