Central Serous Chorioretinopathy in Younger and Older Adults

Spaide, Richard F.; Campeas, Laura; Haas, Anton; La, Yannuzzi; Fisher, Yale L.; Guyer, David R.; Slakter, Jason S.; Sorenson, John A.; Orlock, Dennis A.

doi:10.1016/s0161-6420(96)30386-2

Cited by 503 publications

(396 citation statements)

References 17 publications

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“…[1][2][3][15][16][17][18][19][20][21] In a retrospective study, Mudvari et al 29 found that none of the 340 consecutive CSCR patients developed CNV during an approximate 4-year follow-up period (mean of 49 months). However, Spaide et al 30 reported that older patients with CSCR had a lower VA, and were more likely to have diffuse retinal pigment epitheliopathy and secondary CNV than their younger counterparts. Subsequent reports have suggested that classic CNV (mainly type 2) and polypoidal lesions are possible complications of CSCR and may contribute to visual loss in these eyes.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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Purpose To evaluate the results of indocyanine green angiography (ICGA)-guided verteporfin photodynamic therapy (PDT) with half-fluence rate combined with intravitreal application of anti-VEGF in treating choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSCR). Patients and methods In this retrospective cohort study 17 consecutive patients with secondary CNV due to chronic CSCR had their diagnosis verified with fluorescein angiography (FA) and ICGA at baseline. All eyes received either intravitreal ranibizumab (IVR) or bevacizumab (IVB). On the consecutive day following the initial IVR/IVB treatment, ICGAguided verteporfin (6 mg/m 2 ) PDT with halffluence rate (25 J/cm 2 ) was performed on every patient. IVR or IVB was rescheduled on a pro re nata regimen. Main outcome measures were changes in visual acuity (VA) according to the ETDRS letter score and changes in the central foveal thickness (CFT). Results Best-corrected VA at baseline was 65.6 letters (±6.7; n = 17) according to the ETDRS letter score. At 12 months, mean ETDRS letter score improved to 71.2 letters (P = 0.34). CFT was 309 μm and decreased to 216 μm at month 12 control (P = 0.0004). Nine eyes (52.9%) received additional treatment with IVR/IVB due to recurrence of subretinal fluid, with an overall mean number of IVR/IVB treatment of 1.8 ± 3.6 per patient with no systemic side effects during 12 months' follow-up. Conclusions IVR or IVB combined with ICGA-guided half-fluence PDT with verteporfin is effective in treating CNV in chronic CSCR, with choroidal hyperpermeability in ICGA, resulting in stable vision and significant reduction of CFT.

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Section: Discussionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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“…Interestingly, two reports that showed significant visual improvement with PDT in chronic CSC also used FFA rather than ICG, 14,20 considered essential by others. 2,5,6 TTT has been successfully used to treat subfoveal CNV of various aetiologies. [21][22][23] Owing to its thermal nature, TTT may act like conventional photocoagulation in CSC, causing RPE debridement, migration, transformation, and re-proliferation.…”

Section: Discussionmentioning

confidence: 99%

“…A second uncommon type, with widespread alterations of RPE pigmentation in the posterior pole, is termed 'chronic' or 'diffuse retinal pigment epitheliopathy' (DRPE). 2 This subtype is associated with older age, chronic (46 months) detachment of the posterior pole, poorly defined RPE leakage or 'ooze,' multiple pigment epithelial detachments (PED), and poor visual prognosis owing to cystoid macular oedema, foveolar atrophy, subretinal fibrosis, and less commonly, choroidal neovascularization (CNV). [2][3][4][5][6][7][8] In spite of the innumerable studies on CSC, there is continued controversy in the literature on the need, timing, and choice of treatment.…”

Section: Introductionmentioning

confidence: 99%

Transpupillary thermotherapy for subfoveal leaks in central serous chorioretinopathy

Shukla

Kolluru

Vignesh

et al. 2006

Eye

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Aim To evaluate transpupillary thermotherapy (TTT) for the treatment of subfoveal focal leaks in central serous chorioretinopathy (CSC). Methods The patients presenting with long-standing CSC, but without the features of chronicity, were offered the options of TTT, photodynamic therapy (for subfoveal leaks), photocoagulation (for extrafoveal leaks), or observation. The patients who opted for TTT or observation were enrolled in this study. TTT was performed using a spot diameter of 0.5 mm for 1 min. Best-corrected visual acuity (BCVA), status of macular detachment, and fluorescein angiographic status were evaluated at 1, 3, and 6 months. Results This study included 39 patients (40 eyes) with CSC between 4 and 12 months, of whom 25 patients (25 eyes) opted for TTT for subfoveal leaks. Fourteen patients (15 eyes) were followed up without treatment. The groups were comparable in age, sex, and baseline BCVA. Minimum follow-up was 6 months. Within 3 months, TTT resulted in the resolution of the serous detachment in 24 (96%) eyes with a single session; one eye required a repeat treatment. Eight control eyes demonstrated persisting CSC at the last follow-up. Visual acuity improved in 23 (92%) treated and five (33%) control eyes; the difference in outcome was statistically significant (Po0.001). One case developed choroidal neovascularization, which resolved with visual recovery to 20/20 after repeat-TTT. Conclusion TTT resulted in the resolution of CSC with subfoveal angiographic leaks with significant improvement in visual outcome, in comparison to the natural history of persistent CSC.

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“…1 Although the pathogenesis of this condition has been extensively investigated, it remains a matter of controversy. In several hypotheses, choroidal hyperpermeability and dysfunction of RPE have been regarded as strong candidates for the origin of this disorder.…”

Section: Introductionmentioning

confidence: 99%

Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy

Kang

Bai

2011

Eye

127

101

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Objective To assess the change in the choroidal thickness of the unaffected eyes in patients with unilateral central serous chorioretinopathy (CSC). Methods Thirty eyes with unilateral idiopathic CSC and 30 age-matched normal eyes were included in this study. Choroidal thickness was evaluated from images obtained by enhanced depth image optical coherence tomography. The choroidal thicknesses of the affected eyes, unaffected eyes, and normal eyes were analyzed. Choroidal vascular dilation and hyperpermeability on indocyanine green angiography (ICGA) were analyzed and correlated with the changes in choroidal thickness. Results The mean choroidal thicknesses of the affected eyes, unaffected fellow eyes, and normal individuals were 445.58 ± 100.25, 378.35±117.44, and 266.80±55.45 lm, respectively. Compared with normal eyes, subfoveal choroidal thickness was increased significantly in the eyes with active CSC and in the unaffected fellow eyes (Po0.001 in both groups). The choroidal thickness was significantly greater in the eyes with active CSC than in the unaffected fellow eyes (P ¼ 0.003). ICGA revealed choroidal vascular hyperpermeability in 28 (93.3%) eyes with CSC and in 23 (73.3%) unaffected fellow eyes. Choroidal vascular dilation was detected in 21 (70.0%) eyes with CSC and in 18 (60.0%) unaffected fellow eyes. Conclusion Increased choroidal thickness in patients with unilateral CSC was noted not only in the affected eyes, but also in the unaffected fellow eyes. The results of this study suggest that CSC might be an essentially bilateral disorder.

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Central Serous Chorioretinopathy in Younger and Older Adults

Cited by 503 publications

References 17 publications

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Transpupillary thermotherapy for subfoveal leaks in central serous chorioretinopathy

Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy

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