Eplerenone for Central Serous Chorioretinopathy
Condition: Central Serous Chorioretinopathy
MeSH terms: Central Serous Chorioretinopathy
Intervention: Eplerenone 50mg
Intervention description: All patients will receive the same dose of eplerenone.
Intervention MeSH terms: Eplerenone
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 17.0
Sex: All
Minimum age: 18 Years
Maximum age: 65 Years
Healthy volunteers: No
Keywords: Central Serous Chorioretinopathy; Eplerenone; Optical Coherence Tomography; Enhanced Depth Imaging; Subretinal Fluid

Summary:

      -  The goal of the study is to examine the short-term effects and safety of a systemic
           anti-aldosterone medication, eplerenone, in a small group of patients with central
           serous chorioretinopathy (CSCR).

        -  There is currently no standard treatment or therapy for either acute or chronic CSCR, a
           potentially debilitating eye disease.

        -  There is evidence in both animals and humans that high blood serum corticosteroid levels
           can cause or worsen CSCR or findings similar to CSCR in the choroid and retina

        -  Eplerenone, a mineralocorticoid receptor antagonist, has been shown to be of visual and
           anatomic benefit in a small series of 4 patients with chronic CSCR, suggesting that
           decreasing mineralocorticoid action in the eye may improve signs and symptoms of CSCR

        -  The investigators' aim is to evaluate a standardized dose of eplerenone in a controlled
           prospective fashion for both acute and chronic CSCR.

        -  The study consists of taking a standard dose of eplerenone, 50mg once daily, for 1 month

        -  Over the course of the month, patients will be monitored for side effects, as well as
           visual and anatomical response to the medication
    

Eligibility criteria:

        Inclusion Criteria:

          1. Age 18 or over

          2. Ability to give written informed consent

          3. Presence of sub-retinal fluid under the fovea as seen on OCT

          4. Diagnosis of Acute or Chronic CSCR:

               -  Acute CSCR: First presentation to eye clinic with visual symptoms, including
                  decreased vision or visual distortion, and the characteristic appearance of CSCR
                  on examination, fluorescein angiography, and OCT.

               -  Chronic CSCR: Previous diagnosis of CSCR, persistent subretinal fluid on OCT for
                  more than 3 months after initial presentation to the eye clinic, and <50%
                  reduction in fluid thickness on OCT after 3 months. Patients who have had
                  previous treatment for CSCR may be included.

        Exclusion Criteria:

          1. Age less than 18

          2. Persons with impaired decision-making ability.

          3. Women who are known to be pregnant or are actively trying to conceive.

          4. Additional eye disease affecting the macula or posterior retina.

          5. At screening, serum potassium concentration ≥5.0 mEq/L , a serum creatinine
             concentration >2 mg/dL in men and >1.8 mg/dL in women, or a creatinine clearance <50
             mL/min, and during concomitant administration of potassium supplements,
             potassium-sparing diuretics, and/or potent CYP3A4 inhibitors (amifostine,
             cyclosporine, fluconazole, itraconazole, ketoconazole, mifepristone, posaconazole,
             potassium salts, Rituximab, tacrolimus or voriconazole).

          6. Patients with type 2 diabetes will be screened for microalbuminuria with a urinalysis.
             If microalbuminuria is present, these patients will be excluded.