Central serous chorioretinopathy: An evidence-based treatment guideline

Feenstra, Helena M.A.; van Dijk, Elon H.C.; Cheung, Chui Ming Gemmy; Ohno-Matsui, Kyoko; Lai, Timothy Y.Y.; Koizumi, Hideki; Larsen, Michael; Querques, Giuseppe; Downes, Susan M.; Yzer, Suzanne; Breazzano, Mark P.; Subhi, Yousif; Tadayoni, Ramin; Priglinger, Siegfried G.; Pauleikhoff, Laurenz J.B.; Lange, Clemens A.K.; Loewenstein, Anat; Diederen, Roselie M.H.; Schlingemann, Reinier O.; Hoyng, Carel B.; Chhablani, Jay K.; Holz, Frank G.; Sivaprasad, Sobha; Lotery, Andrew J.; Yannuzzi, Lawrence A.; Freund, K. Bailey; Boon, Camiel J.F.

doi:10.1016/j.preteyeres.2024.101236

Cited by 10 publications

(7 citation statements)

References 623 publications

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“…The use of corticosteroids is the most significant external risk factor for developing CSC, with odds ratios as high as 37:1 being reported [ 64 ]. Although rare, in some cases even minimal exposure to corticosteroids exposure has been associated with an increased risk, exacerbation, and/or recurrence of CSC [ 65 , 66 ], suggesting that the increased risk of developing CSC is not solely dependent on the dose or mode of corticosteroid administration, but may also depend on genetic predisposition and/or an increased vulnerability to corticosteroid exposure in some individuals [ 9 ]. The mechanism of corticosteroid-induced CSC may be related to the activation of both the gluco- and the mineralocorticoid (MR) receptors.…”

Section: Discussionmentioning

confidence: 99%

“…Current treatments for CSC mainly include photodynamic therapy (PDT), laser therapy, and anti-vascular endothelial growth factor (anti-VEGF) therapy [ 9 ]. However, PDT is not available in all countries and PDT itself has serious side effects, including ocular events such as choroidal ischemia and subsequent retinal atrophy, as well as systemic events such as headache, back pain, nausea, dyspnea, dizziness, and syncope [ 9 – 11 ]. Conventional laser photocoagulation is only suitable for treating extrafoveal leakage points, and its efficacy against CSC remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional laser photocoagulation is only suitable for treating extrafoveal leakage points, and its efficacy against CSC remains unclear. In addition, adverse events such as scotoma, vision loss, reduced contrast sensitivity, and/or macular neovascularization (MNV) may occur in the treated area due to damage to the neuralretina-RPE-Bruch’s membrane [ 9 , 12 ]. The efficacy of anti-VEGF treatment in treating CSC still lacks clear evidence and the treatment is limited to patients with concurrent macular neovascularization [ 9 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, adverse events such as scotoma, vision loss, reduced contrast sensitivity, and/or macular neovascularization (MNV) may occur in the treated area due to damage to the neuralretina-RPE-Bruch’s membrane [ 9 , 12 ]. The efficacy of anti-VEGF treatment in treating CSC still lacks clear evidence and the treatment is limited to patients with concurrent macular neovascularization [ 9 , 13 ]. Therefore, it is necessary to explore new adjuvant therapeutic measures for CSC.…”

Section: Introductionmentioning

confidence: 99%

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Effects of traditional Chinese medicine in the treatment of patients with central serous chorioretinopathy: A systematic review and meta-analysis

Ru,

Sun,

Zhou

et al. 2024

PLoS ONE

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Several studies have reported the efficacy of traditional Chinese medicine (TCM) for central serous chorioretinopathy (CSC), while some ophthalmologists are concerned that TCM may be a risk factor for CSC as some chinese herbs contain hormonal ingredients. This study aimed to evaluate the efficacy and safety of TCM in treating patients with CSC. Randomized controlled trials (RCTs) and observational studies of TCM for CSC were searched up to July 10, 2023 on the following biological databases without language and publication time restrictions: PubMed, Ovid Medline, Embase, Cochrane Library, The Chinese National Knowledge Infrastructure Database (CNKI), Technology Periodical Database (VIP), Wanfang, and Chinese Biomedical Literature Service System (SinoMed). Review Manager V.5.4.1 and Stata 14 software were used for data analysis. Finally, thirty-eight studies were finally included including 23 RCTs and 15 cohort studies. The meta-analysis showed that compared with the routine treatment alone, the combination of TCM can not only reduce the recurrence rate (OR = 0.29, 95% CI: 0.21,0.40; I2 = 0%) and central retinal thickness (CRT) (MD = - 35.63, 95% CI: - 45.96,-25.30; I2 = 89%) of CSC, but improve patients’ best corrected visual acuity (BCVA) (SMD = 0.86, 95% CI: 0.62,1.11; I2 = 77%); additionally, it has no obvious side effects compared with routine treatment (OR = 0.72, 95% CI: 0.39,1.34; I2 = 10%). Overall, this study shows that the use of TCM does not increase the risk of CSC recurrence; on the contrary, the combination of TCM may reduce the recurrence of CSC and improve BCVA and CRT in patients with CSC compared with conventional treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of traditional Chinese medicine in the treatment of patients with central serous chorioretinopathy: A systematic review and meta-analysis

Ru,

Sun,

Zhou

et al. 2024

PLoS ONE

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“…depend on genetic predisposition and/or an increased vulnerability to corticosteroid exposure in some individuals [9]. The mechanism of corticosteroid-induced CSC may be related to the activation of both the gluco-and the mineralocorticoid (MR) receptors.…”

Section: Plos Onementioning

confidence: 99%

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Central serous chorioretinopathy and the sclera: what we have learned so far

Koizumi,

Imanaga,

Terao

2024

Jpn J Ophthalmol

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Central serous chorioretinopathy (CSC) is a common disorder characterized by serous retinal detachment. Several studies using indocyanine green angiography (ICGA) have revealed that choroidal filling delay, choroidal vascular dilation, and choroidal vascular hyperpermeability are the characteristic findings of CSC. These ICGA findings confirm that choroidal circulatory disturbances are the primary factors in the pathogenesis of CSC. With advancements in optical coherence tomography (OCT), choroidal thickness has been found to be significantly greater in eyes with CSC than in normal eyes. Dilated large choroidal vessels reportedly account for the thickened choroid in eyes with CSC. Although many possible mechanisms and risk factors have been suggested, the pathophysiologic features of choroidal circulatory disturbances and choroidal thickening in eyes with CSC have not yet been fully elucidated. Recently, using anterior segment OCT, we proposed that the sclera may induce choroidal circulatory disturbances since CSC eyes have significantly thicker sclera than do normal eyes. This review summarizes updated information on the close relationship between CSC pathogenesis and the sclera.

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Central serous chorioretinopathy: An evidence-based treatment guideline

Cited by 10 publications

References 623 publications

Effects of traditional Chinese medicine in the treatment of patients with central serous chorioretinopathy: A systematic review and meta-analysis

Effects of traditional Chinese medicine in the treatment of patients with central serous chorioretinopathy: A systematic review and meta-analysis

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Central serous chorioretinopathy and the sclera: what we have learned so far

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