To compare the short-term efficacy of oral spironolactone vs. observation in patients with acute central serous chorioretinopathy.

Forty-seven eyes of 47 patients diagnosed as acute central serous chorioretinopathy from January 2013 to June 2016 were treated with oral spironolactone or were observed. This was a retrospective study involving patients analyzed for changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid height (SRFH).

Oral spironolactone was used to treat 24 eyes and 23 eyes were observed. There were no differences in baseline characteristics including age, sex, BCVA (logMAR), CMT, and SRFH between the two groups. The mean BCVA, CMT, and SRFH improved compared with baseline at 1 month and 2 months in both groups. In comparison between the two groups, the mean BCVA of oral spironolactone group improved more than in the observation group at 2 months ( p = 0.006). There was a significant difference in CMT between the two groups at 1 month and 2 months ( p = 0.017 and p < 0.001, respectively), and there was a significant difference in subretinal fluid height between the two groups at 2 months ( p = 0.007). Complete resolution of subretinal fluid was achieved in 33.3% (8/24) and 21.7% (5/23) of the eyes in the oral spironolactone group and the observation group, respectively, at 2 months ( p = 0.374). There was no serious side effect in patients treated with oral spironolactone.

Both oral spironolactone and observation were effective for the treatment of acute central serous chorioretinopathy. Oral spironolactone was more effective than observation when comparing the best-corrected visual acuity, central macular thickness, and subretinal fluid height. As a noninvasive method for treatment of acute central serous chorioretinopathy, oral spironolactone showed anatomical improvement and improved visual acuity during a short-term period.