Selective retina therapy for acute central serous chorioretinopathy

Klatt, C.; Saeger, Mark; Oppermann, Till; Pörksen, E.; Treumer, Felix; Hillenkamp, Jost; Fritzer, Elfriede; Brinkmann, Ralf; Birngruber, Reginald; Roider, Johann

doi:10.1136/bjo.2009.178327

Cited by 71 publications

(71 citation statements)

References 20 publications

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“…However, all of them were conducted by the same group. A first case series in 2006, comprising 5 patients, showed promising preliminary results in terms of subretinal fluid regression with coexistent PED without any cases of RPE rips [115]. In the same year, another study with 27 patients could also show a very high subretinal fluid regression rate.…”

Section: Treatmentmentioning

confidence: 83%

“…This selective treatment of the RPE is meant to trigger the regeneration of the RPE and a long-term metabolic increase at the chorioretinal junction [116]. Three different studies and case series have been carried out to evaluate the effect of SRT in the setting of CSC [115,117,118]. However, all of them were conducted by the same group.…”

Section: Treatmentmentioning

confidence: 99%

“…SRT is performed with a Q-switched, frequency-doubled Nd:YLF laser beam with a wavelength of 527 nm [115]. This selective treatment of the RPE is meant to trigger the regeneration of the RPE and a long-term metabolic increase at the chorioretinal junction [116].…”

Section: Treatmentmentioning

confidence: 99%

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Central Serous Chorioretinopathy

Liegl¹,

Ulbig²

2014

Ophthalmologica

137

115

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The pathogenesis of central serous chorioretinopathy (CSC) is still not fully understood. The involvement of corticosteroids is undisputed, although their exact role has not been clarified; other parts of the underlying mechanism of CSC have been mainly elucidated by imaging techniques such as fluorescein and indocyanine green angiography. Even though most cases of CSC are self-limiting, severe as well as recurrent courses exist, and for these patients only a limited number of treatment options are available: laser photocoagulation, with a risk of scotoma and choroidal neovascularization, and photodynamic therapy. In this review article, we give an overview of its epidemiology, the current understanding of its pathogenesis as well as systemic and ocular risk factors. We illuminate modern diagnostic tools as well as current treatment options in the context of CSC, particularly in the light of a better understanding of corticosteroids and their receptors involved in its pathogenesis.

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Section: Treatmentmentioning

confidence: 83%

Section: Treatmentmentioning

confidence: 99%

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Central Serous Chorioretinopathy

Liegl¹,

Ulbig²

2014

Ophthalmologica

137

115

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“…Subthreshold micropulse diode laser treatment is applied in an attempt to trigger the regeneration of the RPE and a long-term metabolic increase at the chorioretinal junction, 36 which may increase SRF resorption by the RPE. 37 Micropulse laser treatment is not thought to affect the choriocapillaris directly. The lack of effects on choriocapillary flow in patients after micropulse laser treatment is therefore not surprising.…”

Section: Discussionmentioning

confidence: 99%

OCT Angiography Compared to Fluorescein and Indocyanine Green Angiography in Chronic Central Serous Chorioretinopathy

Teussink

Breukink

Grinsven

et al. 2015

Invest. Ophthalmol. Vis. Sci.

151

106

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PURPOSE. Abnormal choroidal blood flow is considered important in the pathogenesis of chronic central serous chorioretinopathy (CSC). Optical coherence tomography (OCT) angiography can image ocular blood cell flow and could thus provide novel insights in disease mechanisms of CSC. We evaluated depth-resolved flow in chronic CSC by OCT angiography compared to fluorescein angiography (FA) and indocyanine green angiography (ICGA).METHODS. Eighteen eyes with chronic CSC, and six healthy controls, were included. Two human observers annotated areas of staining, hypofluorescence, and hotspots on FA and ICGA, and areas of abnormal flow on OCT angiography. Interobserver agreement in annotating OCT angiography and FA/ICGA was measured by Jaccard indices (JIs). We assessed colocation of flow abnormalities and subretinal fluid visible on OCT, and the distance between hotspots on ICGA from flow abnormalities.RESULTS. Abnormal areas were most frequently annotated in late-phase ICGA and choriocapillary OCT angiography, with moderately high (median JI, 0.74) and moderate (median JI, 0.52) interobserver agreement, respectively. Abnormalities on late-phase ICGA and FA colocated with those on OCT angiography. Aberrant choriocapillary OCT angiography presented as foci of reduced flow surrounded by hyperperfused areas. Hotspots on ICGA were located near hypoperfused spots on OCT angiography (mean distance, 168 lm). Areas with current or former subretinal fluid were colocated with flow abnormalities.CONCLUSIONS. On OCT angiography, chronic CSC showed irregular choriocapillary flow patterns, corresponding to ICGA abnormalities. These results suggest focal choriocapillary ischemia with surrounding hyperperfusion that may lead to subretinal fluid leakage.

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“…A randomized prospective study of 30 patients with chronic central serous chorioretinopathy of at least 3 months' duration with 14 eyes randomized to SRT and 16 eyes as controls found a statistically significant improvement in mean visual acuity with 12.7 letters gained in the laser group versus 6.3 letters gained in the control group (p=0.04). SRT also resulted in less subretinal fluid with a decrease of 203 microns in retinal thickness with laser versus 41 microns in control patients at 3 months (p=0.005) [47] . A prospective uncontrolled study of 39 patients with diabetic macular edema found an improvement of 2.4 letters of vision 6 months after laser application (p=0.02).…”

Section: Paulus Ym Retinal Lasersmentioning

confidence: 93%