Ketoconazole in the treatment of Central Serous Chorioretinopathy : A pilot studyPurpose: The aim of this study is to evaluate a possible effect of systemic Ketoconazole on visual acuity (VA) and retinal thickness in patients with acute central serous chorioretinopathy (CSCR). Materials and Methods: 15 consecutive patients were treated with Ketoconazole 200 mg/d over a period of 4 weeks, while the other 15 patients served as control group. Baseline examination and review after 4 weeks included VA testing and measurement of neuroretinal or pigment epithelial detachment by optical coherence tomography (OCT). Fluorescein angiography was performed to verify the diagnosis. Results: At baseline, mean VA in Snellen units was 0.6±0.2 (Log MAR 0.2±0.7) in the treatment group and 0.7±0.3 (Log MAR 0.2±0.5) in the control group. On OCT, mean neuroretinal or pigment epithelial detachment measured 288±163 µm in the Ketoconazole group and 225±51 µm in the control group, respectively. Four weeks later, mean VA improved in both groups. On OCT, neuroretinal or pigment epithelial detachment decreased also in the treatment group and the control group. The differences were statistically not significant. Conclusion: While a pharmacological decrease in endogenous cortisol synthesis appears to be a rational approach in the treatment of CSCR, systemic Ketoconazole at 200mg/d was not associated with a significantly better outcome in this preliminary study
