Spironolactone as a Therapeutic Alternative for the Bullous Variant of Central Serous Chorioretinopathy

PURPOSE: To report a case of the bullous variant of central serous chorioretinopathy successfully treated with spironolactone, a mineralocorticoid receptor antagonist. METHODS: Case report of a patient including fluorescein angiography, optical coherence tomography, and color fundus photography. RESULTS: Initially managed as a multifocal choroiditis, the use of oral and peribulbar corticoids worsened the serous retinal detachment. Taking in consideration this response, she was then diagnosed with a bullous variant of central serous chorioretinopathy and treated with 50 mg of spironolactone per day. Resolution of the serous retinal detachment, decrease in choroidal thickness on optical coherence tomography, and absence of leaks in fluorescein angiography was achieved 2 months posterior to the first dose of oral spironolactone. CONCLUSION: We suggest the use of mineralocorticoid receptor antagonists, such as spironolactone, as a therapeutic alternative to more aggressive available treatments for the bullous variant of central serous chorioretinopathy.