Mineralocorticoid receptor antagonists as a potential treatment option in persistent subretinal fluid following the repair of a rhegmatogenous retinal detachment

PURPOSE: To report the resolution of subretinal fluid persisting more than a year following retinal detachment surgery resolving with a short term course of mineralocorticoid receptor antagonists use. OBSERVATIONS: A 41 year-old, highly myopic male presented with a temporal rhegmatogenous retinal detachment involving the macula. The tear was treated with a radial sponge without subretinal fluid (SRF) drainage. Post-operatively, SRF persisted for more than 1 year with only slight improvement in visual acuity. On OCT, slow regression of subretinal fluid was noted. In order to stimulate the RPE pump, a systemic mineralocorticoid receptor antagonist (spironolactone 50 mg) was initiated after discussion with the patient. After one month of therapy, there was a complete resolution of SRF and the visual acuity improved. Two years later, there was no reaccumulation of SRF and the visual acuity remained stable. CONCLUSIONS AND IMPORTANCE: A short term of course of mineralocorticoid receptor antagonist is a potential treatment for persistent subretinal fluid following a successful detachment surgery.