Bilateral bullous central serous chorioretinopathy treated with PDT and eplerenone

PURPOSE: To report a case evaluating PDT and eplerenone therapy in a patient with bilateral bullous central serous chorioretinopathy. OBSERVATIONS: A 30-year-old male was referred for worsening bilateral bullous central serous chorioretinopathy (bCSCR) despite oral eplerenone therapy. Photodynamic therapy (PDT) was performed in the right eye with significant improvement of bullous retinal detachment, near-complete resolution of subfoveal subretinal fluid, and improvement of vision from 20/200 to 20/25. The left eye had persistent subretinal fluid despite continued eplerenone therapy. Neither eye worsened when eplerenone was withdrawn. Total follow up was 3.5 years. CONCLUSIONS AND IMPORTANCE: This case demonstrates a significant and durable effect of PDT in bullous CSCR and suggests a lack of response to eplerenone.