Central serous chorioretinopathy

Abstract

Central serous chorioretinopathy (CSC) has remained an enigmatic disease since its initial description by Von Graefe. Over the years, multiple risk factors have been recognized: these include psychological stress, behavioral traits, and corticosteroids. The basic pathophysiology of CSC involves choroidal thickening, vascular congestion, altered choroidal blood flow (ChBF), and choroidal hyperpermeability, leading to retinal pigment epithelium decompensation and subsequent neurosensory detachment. Multiple organ systems, mainly the nervous, cardiovascular, endocrinal, and renal systems participate in the control of the vascular tone and the ChBF via hypothalamus–pituitary–adrenal axis and renin–angiotensin–aldosterone system, while others such as the hepatic system regulate the enzymatic degradation of corticosteroids. Many vasoactive and psychotropic drugs also modulate the ocular perfusion. In addition, there are anatomical and genetic predispositions that determine its progression to the chronic or recurrent form, through cellular response and angiogenesis. We herein review the basic pathophysiology and immunogenetics in CSC along with the role of multiple organ systems. With this background, we propose an etiological classification that should provide a framework for customized therapeutic interventions.

Ocular Manifestations in a Context of Primary Hyperparathyroidism: A Report of Two Cases

“…Recent studies have demonstrated an increased vulnerability of choroidal blood flow to vascular variations in patients with CSCR 13 , 14 . Disturbances of the endocrinal system can lead to a dysregulation of the vascular tone and could therefore contribute to the pathogenesis of CSCR 15 . A direct causative relation of a hyperparathyroidism or additive aggravating effect of an imbalance in the hypothalmic-pituary-adrenal and/or renin-angiotension-aldosterone axes were discussed in our case.…”

Correlative study on retinal microvascular changes and sex hormones in male patients with central serous chorioretinopathy

“…Subsequently, this causes retinal neuroepithelial detachment in the macular area combined with focal retinal pigment epithelial detachment. Patients experience several clinical manifestations, including mild visual loss, darkening of vision, hue changes, and central relative dark areas [11][12][13][14]. The incidence of CSC differs significantly between genders and occurs predominantly in men and rarely in women.…”

The role of inflammation in central serous chorioretinopathy: From mechanisms to therapeutic prospects

“…In recent times, it has been acknowledged that inflammation plays a crucial role in the advancement and onset of CSC. Hence, targeting inflammation through molecular markers could be a promising treatment strategy for CSC( Jain et al, 2022 ). The inflammatory process of CSC involves a dynamic interplay between cytokines, chemokines, and adhesion molecules.…”

“…In recent times, it has been acknowledged that inflammation plays a crucial role in the advancement and onset of CSC. Hence, targeting inflammation through molecular markers could be a promising treatment strategy for CSC (Jain et al, 2022).…”