Mineralocorticoid receptor antagonists demonstrate differential efficacy in the management of central serous chorioretinopathy (CSCR). In a systematic review and meta-analysis of seven randomized controlled trials involving 283 patients, nonselective MR antagonism with spironolactone was associated with significant improvement in best-corrected visual acuity (BCVA) and a meaningful reduction in subretinal fluid (SRF) height compared with placebo, whereas the selective agent eplerenone improved BCVA but did not achieve a significant reduction in SRF.
Network meta-analysis further indicated that spironolactone was superior to eplerenone in improving visual acuity, with no significant difference between agents in SRF reduction. These findings suggest a more pronounced functional benefit with spironolactone in CSCR, highlighting the importance of receptor selectivity when considering MR…
