# Optical Coherence Tomography-Based Positive Predictors of Eplerenone Therapy in Chronic Central Serous Chorioretinopathy: A Retrospective Study

## TL;DR

This study found that certain optical coherence tomography (OCT) features can predict how well patients with chronic central serous chorioretinopathy respond to eplerenone treatment.

## Contribution

The study identifies specific OCT biomarkers that predict positive outcomes for eplerenone therapy in chronic CSCR patients.

## Key findings

- Eighty-eight percent of patients showed significant reduction in subretinal fluid after eplerenone treatment.
- The absence of pigment epithelial detachments and double-layer signs was associated with better treatment response.
- Central macular thickness decreased significantly over the six-month follow-up period.

## Abstract

Purpose: This study aimed to investigate optical coherence tomography (OCT) biomarkers as potential predictors of treatment response in chronic central serous chorioretinopathy (CSCR).

Materials and methods: It was a retrospective cohort study that included 42 patients with chronic CSCR. After complete ocular and hematological examinations, all patients received 50 mg/day of oral eplerenone for three months and were followed for at least six months. All participants were divided into two groups: Group 1 participants with a positive response to treatment (complete resolution of subretinal fluid (SRF) at six months) and Group 2 poor responders (moderate or less than 50% reduction in SRF from baseline). The primary outcome measure was the resolution of SRF, and various OCT biomarkers like central macular thickness (CMT), pigment epithelial detachments (PED), double-layer sign, elongation of the photoreceptor's outer segment, the integrity of the external limiting membrane, the integrity of the ellipsoid zone, hyperreflective foci in the outer segment, and subretinal deposits in the SRF were assessed.

Results: The mean age was 41.33 ± 10.75 years, and 34 participants were male. Thirty-seven (88.1%) of the participants had good responses to eplerenone, with the mean height of SRF decreasing significantly from a maximum of 269.74 µm to a minimum of 21.86 µm at six months (p<0.001). The mean CMT decreased from the first visit time point to the third visit time (p<0.001). Logistic regression analysis assessed the absence of PED and double-layer signs associated with a good response.

Conclusion: The eplerenone therapy seems to be efficient for chronic CSCR, and OCT can be an invaluable aid to the treating physician.