Purpose: We sought to evaluate the time-dependent efficacy and safety of eplerenone for central serous chorioretinopathy. Methods: A systematic search was performed from inception to May 2023 in the Medline, EMBASE, and Cochrane literature databases to find randomized controlled trials that have administered oral eplerenone therapy to central serous chorioretinopathy patients. Results: Five randomized controlled trials were included in the final analysis. Among a total of 252 central serous chorioretinopathy patients, 134 were included in the eplerenone group and 118 were included in the control group. The best-corrected visual acuity was statistically significantly improved in the eplerenone group compared to the control group (95% confidence interval [CI], -0.08 to -0.02; p = 0.001). After meta-analysis was performed at each follow-up point, it was found that eplerenone statistically significantly improved the best-corrected visual acuity compared to the control group at 2 and 3 months after starting oral eplerenone therapy, but there was no statistically significant difference at 6 months. Subretinal fluid, chorioretinal thickness, central macular thickness, and complications showed no statistically significant differences between the eplerenone and control groups (p = 0.43, 0.67, 0.64, and 0.12, respectively). The difference in the risk of complications occurring between the eplerenone and control groups also didn’t show statistical significance (p = 0.12). Conclusions Although eplerenone is not superior to a control protocol when considering anatomical improvements, the best-corrected visual acuity seems to improve up to 3 months superiorly compared to in the control group when oral eplerenone therapy is administered for central serous chorioretinopathy. In addition, the complications of eplerenone are tolerable. Therefore, clinically short-term use of eplerenone up to 3 months in central serous chorioretinopathy patients can be considered.

BACKGROUND AND OBJECTIVES: This study was performed to investigate whether stem cell therapy enhances β cell function by meta-analysis with proper consideration of variability of outcome measurements in controlled trial of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients. METHODS: A systematic search was performed from inception to January 2018 in PubMed, EMBASE, and Cochrane databases. β cell function was assessed by stimulated C-peptide, fasting C-peptide, normal glycosylated hemoglobin levels (HbA1C), and exogenous insulin dose patterns. The quality of the studies were assessed by both the Cochrane Collaboration's Risk of Bias (ROB) for Randomized controlled trials and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized controlled trials. RESULTS: From the selected final 15 articles, total of 16 trials were analyzed. There were 6 T1DM trials (total 153 cases) and 10 T2DM trials (total 457 cases). In T2DM patients, the changes in stimulated C-peptide, HbA1c, and exogenous insulin dose versus baseline showed a favorable pattern with a significant heterogeneity in stem cell therapy. In T1DM, there was no significant difference between control group and stem cell therapy group in three indicators except for HbA1c. Most of the studies were rated as having high risk of bias in the quality assessment. CONCLUSIONS: The stem cell therapy for DM patients is not effective in T1DM but seems to be effective in improving the β cell function in T2DM. However the observed effect should be interpreted with caution due to the significant heterogeneity and high risk of bias within the studies. Further verification through a rigorously designed study is warranted.
Bias (Epidemiology) ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Population Characteristics ; Stem Cells