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Giacomo Boscia,1,* Pasquale Viggiano,1,* Federica Marzulli,1 Maria Oliva Grassi,1 Pasquale Puzo,1 Stefano Dore,2 Antonio Pinna,2 Giovanni Alessio,1 Francesco Boscia1 1Department of Translational Biomedicine Neuroscience, University of Bari âAldo Moroâ, Bari, Italy; 2Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy*These authors contributed equally to this workCorrespondence: Pasquale Viggiano, Department of Translational Biomedicine Neuroscience, University of Bari âAldo Moroâ, Piazza Giulio Cesare, 11, Bari, Italy, Tel +390805593728, Email pasquale.viggiano90@gmail.comPurpose: To assess the long-term morpho-functional retinal and choroidal changes in chronic central serous chorioretinopathy (cCSC) pachychoroid eyes in response to continuous oral eplerenone (EPL) treatment.Methods: This pilot study was conducted on patients with unilateral exudative cCSC. We enrolled a total of 17 exudative cCSC and 17 non-exudative fellow eyes of 17 patients. Baseline best-corrected visual acuity (BCVA) and anatomical (structural optical coherence tomography [OCT] and OCT angiography) parameters in both eyes were collected at baseline. Follow-up data were collected at 6, 12, and 48 months after initiation of EPL treatment.Results: (i) Exudative cCSC eyes: Compared with baseline (0.34± 0.13 LogMAR), BCVA significantly improved at follow-up examinations (6 months: 0.28± 0.13 LogMAR, p=0.039; 12 months: 0.22± 0.11 LogMAR, p=0.025; 48 months: 0.21± 0.08 LogMAR, p=0.028). Furthermore, there was a significant reduction from baseline in all structural OCT parameters (subretinal fluid and subfoveal choroidal thickness [SFCT]; p< 0.05). (ii) Non-exudative fellow eyes: There was no significant change in BCVA. There was a significant reduction from baseline in SFCT and choriocapillaris flow deficit percentage (p< 0.05).Conclusion: In this pilot study, continuous oral EPL therapy in cCSC pachychoroid eyes resulted in long-term morpho-functional improvement. The beneficial effect of EPL occurred within the first year and was maintained after four years. Based on these preliminary observations, EPL may be effective in the exudative forms of CSC.Keywords: central serous chorioretinopathy, choriocapillaris reperfusion, OCT and OCTA |
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