Central serous chorioretinopathy: an update on pathogenesis and treatment

Gemenetzi, M; Salvo, Gabriella De; Lotery, Andrew

doi:10.1038/eye.2010.130

Cited by 296 publications

(273 citation statements)

References 117 publications

(112 reference statements)

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“…All of the following characteristics had to be present: serous SRF on SD-OCT, ≥ 1 areas of multifocal diffuse leakage on FA, and corresponding hyperfluorescence on ICGA, as described previously. 3 Patients with the presence of other relevant retinal diagnoses, such as choroidal neovascularisation or polypoidal choroidal vasculopathy, were excluded. Patients without a follow-up examination within the first 2 months after treatment were also excluded.…”

Section: Methodsmentioning

confidence: 99%

“…1 Choroidal dysfunction is an important cause for retinal pigment epithelium (RPE) dysfunction and subretinal fluid (SRF) accumulation in CSC. 2,3 In CSC two manifestation forms can be distinguished, the acute and the chronic form. The acute CSC is characterized by a focal leakage point ('hot spot') in the RPE and usually resolves without any treatment within a few weeks.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Scholz

Altay

Fauser

2016

Eye

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Purpose To compare the short-term treatment outcome of the 577 nm subthreshold micropulse laser (SML) and half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC) and persistent subretinal fluid (SRF). Methods This retrospective study included 100 eyes of 100 consecutive patients who were treated with the 577 nm SML (Supra Scan, Quantel Medical) (n = 42) or half-dose PDT (n = 58) for cCSC. The treatment was applied at the leakage sites in the fluorescein and indocyanine green angiography. The treatment success was evaluated 6 weeks after treatment using best-corrected visual acuity, central retinal thickness, and resolution of SRF in spectral domain optical coherence tomography. Results Patients showed treatment response more often in the SML group compared with the PDT group (treatment response after SML: 33 eyes (79%), PDT: 34 eyes (59%), P = 0.036, χ 2 test). The CRT decreased significantly after both treatments (mean CRT before SML: 445 ± 153 μm, after SML: 297 ± 95, Po0.001; mean CRT before PDT: 398 ± 88 μm, after PDT: 322 ± 93 μm, Po0.001, Wilcoxon's signed-rank test). The decrease in CRT was statistically significantly higher in the SML group (decrease in CRT after SML: − 148 ± 163 μm, after PDT: − 76 ± 104 μm, P = 0.041, Mann-Whitney U-test). Conclusions Both the half-dose PDT and the 577 nm SML are potent treatments for cCSC with persistent SRF. More patients showed treatment response to the SML treatment and SML leads to a greater decrease in CRT.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Scholz

Altay

Fauser

2016

Eye

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“…1,2,5,6 Hypotheses include abnormal alterations at the retinal pigment epithelium (RPE) level 2,3,7 and choroidal vascular hyperpermeability, as demonstrated on indocyanine green angiography. [7][8][9] CSC has a high spontaneous remission rate, but there is evidence of the benefit of early treatment. [10][11][12] CSC with single, extrafoveal leaking point can be treated using focal photocoagulation to shorten the duration of symptoms without altering the final visual outcomes and the recurrent rate.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a risk of complications, including RPE atrophy, choriocapillary hypoperfusion, and the development of CNV, especially with standard-dose PDT. 9,20 Halfdose PDT seems to be effective and safe, but its long-term efficacy is unknown.…”

Section: Introductionmentioning

confidence: 99%

Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review

Younghae

et al. 2013

Eye

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Purpose To review and evaluate the effects of intravitreal bevacizumab injection (IVB) in centralserous chorioretinopathy (CSC) by meta-analysis. Patients and methods Clinical controlled studies that evaluated the effect of IVB in CSC were identified through systematic searches of Embase, PubMed, and the Cochrane Central Register of Controlled Trials. Data on the bestcorrected visual acuity (BCVA) in logMAR and central macular thickness (CMT) in mm at baseline and 6 months after IVB were extracted and compared with those treated by simple observation.Results Four clinical controlled studies were included in the meta-analysis. The IVB injection group achieved better BCVA at a follow-up of 6 months. However, the analysis showed that there were no significant differences of BCVA at 6 months after injection between IVB group and the observation group ( À 0.02 logMAR, 95% CI À 0.14 to 0.11, P ¼ 0.80). The analysis of the reduction in CMT revealed that the difference between groups was not statistically significant ( À 8.37 lm, 95% CI À 97.26 to 80.52, P ¼ 0.85). No report assessed severe complications or side effects of IVB in patients with CSC. Conclusions Meta-analysis failed to verify the positive effect of IVB in CSC based on the epidemiological literature published to date.

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“…1 Two theories in the pathogenesis of CSC have been proposed: one is choroidal dysfunction and the other is RPE dysfunction theory. 2 Although the evidence for a choroidal vasculopathy in CSC is strong, the underlying mechanism of choroidal disease remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

Correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy

Goktas

2014

Eye

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Correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy A Goktas AbstractPurpose To evaluate the correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy (CSC). Methods Twenty patients with acute unilateral treatment-naive idiopathic CSC and 20 age-matched normal eyes were included in this prospective cross-sectional study. Subretinal fluid volume (SRFV) of study eyes was estimated using a built-in segmentation-modifying tool of Spectralis spectral-domain optic coherence tomography (SD-OCT). Subfoveal choroidal thickness (SCT) (measured with enhanced depth imaging-OCT) and macular volume (MV) were also determined. The correlation of SRFV with SCT and MV was analyzed statistically. Results There was no significant correlation of SRFV with SCT and MV in the study eyes (r ¼ 0.062, P ¼ 0.796 and r ¼ À0.061, P ¼ 0.798, respectively). The mean SCT of the study eyes, the fellow eyes and the control eyes were 461.4±101.4, 375.3±103.7, 287.6±62.5 mm, respectively (Po0.001). The mean modified MV (determined excluding SRF volume) of the study eyes, the macular volume of the fellow and the control eyes was 8.57 ± 0.59 mm 3 , 8.75 ± 0.4 mm 3 and 8.73±0.38 mm 3 , respectively (P40.05). Conclusions The current study shows that subretinal fluid volume does not correlate with subfoveal choroidal thickness. This novel finding suggests that formation of subretinal fluid is not solely associated with choroidal vasculature in acute CSC.

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Central serous chorioretinopathy: an update on pathogenesis and treatment

Cited by 296 publications

References 117 publications

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review

Correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy

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