{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:05:43Z","timestamp":1784624743405,"version":"3.55.0"},"reference-count":40,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: To evaluate whether the combination of oral eplerenone and half-dose full-fluence photodynamic therapy (HD-FF PDT) provides greater efficacy than HD-FF PDT alone in persistent central serous chorioretinopathy (CSCR). Methods: This monocentric, retrospective, observational study included patients with persistent (&gt;6 months) simple or complex CSCR who had previously undergone either half-dose full-fluence photodynamic therapy (HD-FF PDT) alone or HD-FF PDT combined with oral eplerenone as part of routine clinical practice between September 2024 and March 2025. Functional and morphological data collected at baseline and at 1, 3, and 6 months after treatment were retrospectively reviewed. An artificial intelligence\u2013based algorithm was used to analyze OCT scans, quantifying subretinal and intraretinal fluid volumes (SRFV, IRFV) and assessing ellipsoid zone and external limiting membrane integrity, hyperreflective foci, subfoveal choroidal thickness (SCT), and central macular thickness (CMT). Results: Fifty patients (53 eyes; mean age 52 years) were included, with no significant baseline differences between groups. Best-corrected visual acuity improved more significantly in Group B at 1 and 6 months (p = 0.032 and p = 0.009, respectively). At 6 months, subretinal fluid volume (SRFV), quantified by AI-based OCT analysis, was significantly lower in the combined therapy group (p = 0.014). An AI-defined complete resolution of subretinal fluid (SRFV &lt; 0.010 mm3) was achieved more frequently in Group B than in Group A (77% vs. 22%, p = 0.001). Conclusions: Although HD-FF PDT remains the standard treatment for persistent CSCR, adjunctive therapy with the mineralocorticoid receptor antagonist eplerenone may enhance subretinal fluid reabsorption and improve mid-term anatomical and functional outcomes.<\/jats:p>","DOI":"10.3390\/jcm15145701","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:14:27Z","timestamp":1784621667000},"page":"5701","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional and Structural Outcomes of Photodynamic Therapy (PDT) With or Without Eplerenone for Central Serous Chorioretinopathy"],"prefix":"10.3390","volume":"15","author":[{"given":"Giulia","family":"Gregori","sequence":"first","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Centini","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2119-9752","authenticated-orcid":false,"given":"Lorenzo","family":"Mangoni","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0377-7491","authenticated-orcid":false,"given":"Alessio","family":"Muzi","sequence":"additional","affiliation":[{"name":"Eye Clinic, Humanitas Gradenigo, 10153 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4360-4627","authenticated-orcid":false,"given":"Daniela","family":"Fruttini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Perugia, S. Maria della Misericordia Hospital, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Quarta","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, University G. D\u2019Annunzio Chieti-Pescara, 66013 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5856-6686","authenticated-orcid":false,"given":"Maria Ludovica","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, University G. D\u2019Annunzio Chieti-Pescara, 66013 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-5314","authenticated-orcid":false,"given":"Clara","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research, and Child Health, Eye Clinic, University of Florence, AOU Careggi, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Bongiovanni","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Mastropasqua","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, University G. D\u2019Annunzio Chieti-Pescara, 66013 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Mariotti","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-2488","authenticated-orcid":false,"given":"Marco","family":"Lupidi","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy"},{"name":"Fondazione Italiana Macula ETS, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref_1","unstructured":"Chhablani, J. 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