Central serous chorioretinopathy: Current update on management

Abstract

Central serous chorioretinopathy (CSC), the fourth most common nonsurgical retinopathy with a usual self-limiting course, is known to present with persistent or recurrent form with distressing visual loss. Evolution of newer mutimodal imaging techniques have revolutionized the understanding about the pathophysiology of CSC, and hence the diagnosis and management. Multifactorial etiopathology of CSC promotes the use of multiple treatment modalities. With advances in investigative options, treatment options including conventional focal laser, micropulse laser, photodynamic therapy, and transpupillary thermotherapy are also advancing and refining. Medical management for CSC is also under evaluation with a wide spectrum of new drugs in vogue. However, standard of treatment is yet to be established through randomized clinical trials. This review article discusses the current approach to multimodal treatment options for CSC including conventional as well as newer therapeutic modalities.

To evaluate the microcirculation of retinochoroid capillary between acute and chronic central serous chorioretinopathy with OCTA

“…Previous studies have also shown that the impairment in visual function of cCSC patients were more severe than aCSC patients. [ 20 , 21 ] Therefore, early intervention should recommend and may help reduce the risk of structural and functional further impairment in patients with early stage of CSC. Further analysis of the data showed that the VDIR of patients with CSC was significantly lower than that of normal control.…”

Deep Learning for Detecting Subretinal Fluid and Discerning Macular Status by Fundus Images in Central Serous Chorioretinopathy

“…As the fourth most common nonsurgical retinopathy, central serous chorioretinopathy (CSC) is an idiopathic ophthalmopathy in which the neurosensory retina is often detached in the central macular region due to serous leakage from defects of the retinal pigment epithelium, causing a condition where fluid accumulates under the retina and thus causes a visual impairment (Wang et al, 2008;Manayath et al, 2018). In Western countries, such as the United States, a population-based study reported that annual age-adjusted incidences of CSC from 1980 to 2002 were 9.9 and 1.7 per 100,000 in men and women, respectively, in a predominantly Caucasian population (van Rijssen et al, 2019).…”

“…Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are more sensitive examinations for detecting CSC in clinical work. However, these imaging methods are still not widely available and expensive, especially in some less developed countries and regions (Daruich et al, 2015;Manayath et al, 2018;Zhen et al, 2020). In addition, FFA, as an invasive examination, sometimes leads to severe allergic reactions such as nausea and shock caused by fluorescent dye, which is not suitable for routine detection of SRD (Soomro et al, 2018;He et al, 2020).…”

Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

“…In this type of laser, the continuous wave (CW) laser is split into microsecond pulses to provide a therapeutic effect without causing any damage to the retinal tissue but causing the expression of heat shock protein [ 2 ]. Another option for chronic CSCR is photodynamic therapy, which is considered superior to microsecond pulse laser in terms of proportion of patients with complete resolution of subretinal fluid; however, being an invasive procedure and has a risk of overdosing and collateral damage retinal damage [ 3 , 4 ].…”