gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Ketoconazole in the treatment of idiopathic central serous chorioretinopathy

Meeting Abstract

  • corresponding author A. Golshahi - Dept. of Ophthalmology, University of Bonn Medical Center, Bonn
  • D. Klingmüller - Institute of Clinical Biochemistry, University of Bonn Medical Center, Bonn
  • F. G. Holz - Dept. of Ophthalmology, University of Bonn Medical Center, Bonn
  • N. Eter - Dept. of Ophthalmology, University of Bonn Medical Center, Bonn

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.01.09

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Veröffentlicht: 22. September 2004

© 2004 Golshahi et al.
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Elevated endogenous glucocorticoid production and exogenous glucocorticoid application (systemic, inhalative, intraarticular) are said to play a role in the pathogenesis of Idiopathic Central Serous Chorioretinopathy (ICSC) and can be responsible for the disease in the absence of other factors. Ketoconazole, a fungicide of the Imidazole group, inhibits the endogenous cortisol synthesis and is therefore also used in the treatment of Cushing's disease. The aim of this study was to investigate a possible effect of Ketoconazole in the treatment of patients with ICSC.


Out of 28 patients with ICSC, 14 patients were treated with Ketoconazole 200 mg/d over a period of 4 weeks, the other 14 served as controls. Baseline examination and follow-up visit after 4 weeks included testing for visual acuity and measurement of neuroretinal or pigment epithelial detachment by optical coherence tomography (OCT). Fluorescein angiography was performed to verify the diagnosis. To evaluate the systemic effect of the Ketoconazole treatment , twenty four hour urinary free cortical secretion was measured.


In the follow-up, mean visual acuity increased by an average of 0.12 in the treatment group and 0.1 in the control group. Neuroretinal or pigment epithelial detachment decreased by 145 μm in the Ketoconazole group and 92 μm in the control group, respectively. However, the differences in visual acuity and OCT results between both groups missed statistical significance.


A decrease in endogenous cortisol synthesis seems to be a reasonable approach in the treatment of ICSC. However, the efficacy of a 200 mg/d Ketoconazole therapy still has to be proven.