Effect of Spironolactone in Treating Chronic Non-resolutive Central Serous Chorioretinitis

Evaluation de la Spironolactone Dans le Traitement Des choriorétinites séreuses Centrales Non résolutives à Trois Mois

The objective of the study is to evaluate the effect of spironolactone on 16 patients presenting with chronic non-resolutive central serous chorioretinitis (CSCR) and to evaluate whether spironolactone can resolve sub retinal fluid in these patients. CSCR is a major cause of visual loss in the young population. It is characterized by sub retinal fluid under the retina and retinal pigment epithelial detachments. The exact causes of the disease remain unknown but a choroidopathy has been suggested. Moreover, corticotherapy and stress are known risk factors of CSCR. Our preclinical studies have demonstrated that the mineralocorticoid pathway could be involved in the control of choroidal blood flow. The investigators propose to evaluate the mineralocorticoid receptors antagonist spironolactone in the treatment of CSCR. Criteria of efficacy Endpoint: reduction of subretinal fluid ≥ 40 microns Secondary endpoint: visual acuity gain ≥ 15 EDTRS letters

Inclusion Criteria: Patient between 18 and 60 years CSCR affecting the macula and non-resolutive for at least 3 months Patients having given and signed informed consent Vital prognosis non engaged for the next 6 months. Exclusion Criteria: Other ocular pathology Neovascularization, Diabetes Uveitis Ocular surgery in the last 3 months Allergy to fluorescein or indocyanine green Pregnancy or no contraception Renal or liver insufficiency Kaliemia ≥ 5.5 mmol/l Criteria of efficacy