Central serous chorioretinopathy: what we have learnt so far

Abstract

ABSTRACT.Central serous chorioretinopathy (CSCR) is a common retinal cause of visual loss. The mainstays of management are observation, photodynamic therapy (PDT) and laser procedures. Over the past decade, there has been rapid development in the existing and novel imaging techniques, functional testing and management of CSCR. However, there is no convincing treatment designed for CSCR yet. In recent years, the advances in PDT, with various adjustments in fluence and verteporfin dosage, and the comparisons between different types of PDT for acute and chronic CSCR in recent studies have provided greater insights into the role of PDT in treating CSCR. Novel laser procedures, such as the diode micropulse laser, have shown comparable efficacy to conventional lasers without laser-induced damage. Antivascular endothelial growth factor, which was originally developed for treating cancers, has emerged to be a potentially effective treatment for CSCR. The potential role of mineralocorticoid receptor antagonists in treating CSCR has provided greater understanding of the pathogenesis. Based on the relevant studies, mainly from the past decade, we discuss updates to the management of CSCR according to the risk factor modifications, pharmacological interventions, PDT and laser procedures and concluded that PDT is the current best option for CSCR.

Optical Coherence Tomography Angiography Offers New Insights into Choriocapillaris Perfusion

“…Despite tremendous efforts using various therapeutic approaches such as photodynamic therapy, laser coagulation, anti-VEGF therapy, or mineralocorticoid receptor antagonists, there is no convincing treatment designed for CSC so far [60].…”

Visual and anatomical outcomes of spironolactone therapy in patients with chronic central serous chorioretinopathy

“…This channel induces dilation of choroidal vessels,[2] and inactivates endothelial potassium channels, which are upregulated by aldosterone. So this group of drugs can prevent aldosterone-induced choroidal thickening, which might be involved in the pathophysiology of CSC.…”

“…[1] The condition is six times more common in men than in women,[2] and has an overall incidence of approximately 1 in 10,000. [3] In chronic CSC, subretinal fluid (SRF) does not resolve spontaneously within a few months[4], which causes anatomical damage to the RPE, and permanent damage to visual function.…”

Antiretinal antibodies in central serous chorioretinopathy: prevalence and clinical implications

“…Moreover, the optimal treatment for CSC is unknown (Wong et al. ). Central serous chorioretinopathy (CSC) is up to six times more common in men (estimated mean annual age‐adjusted incidence: 9.9 per 100 000) compared to women (estimated incidence: 1.7 per 100 000; Kitzmann et al.…”