Chorioretinopathia centralis serosa (CCS)

Baraki, Husnia; Feltgen, Nicolas; Roider, Johann; Hoerauf, Hans; Klatt, C.

doi:10.1007/s00347-010-2154-3

Cited by 20 publications

(25 citation statements)

References 69 publications

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“…Since no ‘gold standard' for the treatment of CSC is available yet, review articles and case series until 2012 suggest carbonic anhydrase, mild laser photocoagulation, SRT and PDT as well as intravitreal injections of bevacizumab, showing heterogeneous results [30,31,32]. However, since it is known that glucocorticoids induce and aggravate CSC and are known to bind to the mineralocorticoid receptor, a blockade of these receptors might be of benefit in treating this disease with a specific mineralocorticoid receptor antagonist as spironolactone [33].…”

Section: Discussionmentioning

confidence: 99%

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy

Framme¹,

Walter²,

Berger³

et al. 2015

Ophthalmologica

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Purpose: Selective retina therapy (SRT), the confined laser heating and destruction of retinal pigment epithelial cells, has been shown to treat acute types of central serous chorioretinopathy (CSC) successfully without damaging the photoreceptors and thus avoiding laser-induced scotoma. However, a benefit of laser treatment for chronic forms of CSC is questionable. In this study, the efficacy of SRT by means of the previously used 1.7-µs and shorter 300-ns pulse duration was evaluated for both types of CSC, also considering re-treatment for nonresponders. Material and Methods: In a two-center trial, 26 patients were treated with SRT for acute (n = 10) and chronic-recurrent CSC (n = 16). All patients presented with subretinal fluid (SRF) in OCT and leakage in fluorescein angiography (FA). SRT was performed using a prototype SRT laser system (frequency-doubled Q-switched Nd:YLF-laser, wavelength 527 nm) with adjustable pulse duration. The following irradiation settings were used: a train of 30 laser pulses with a repetition rate of 100 Hz and pulse durations of 300 ns and 1.7 µs, pulse energy 120-200 µJ, retinal spot size 200 µm. Because SRT lesions are invisible, FA was always performed 1 h after treatment to demonstrate laser outcome (5-8 single spots in the area of leakage). In cases where energy was too low, as indicated by missing FA leakage, energy was adjusted and the patient re-treated immediately. Observation intervals were after 4 weeks and 3 months. In case of nonimprovement of the disease after 3 months, re-treatment was considered. Results: Of 10 patients with active CSC that presents focal leakage in FA, 5 had completely resolved fluid after 4 weeks and all 10 after 3 months. Mean visual acuity increased from 76.6 ETDRS letters to 85.0 ETDRS letters 3 months after SRT. Chronic-recurrent CSC was characterized by less severe SRF at baseline in OCT and weaker leakage in FA than in acute types. Visual acuity changed from baseline 71.6 to 72.8 ETDRS letters after 3 months. At this time, SRF was absent in 3 out of 16 patients (19%), FA leakage had come to a complete stop in 6 out of 16 patients (38%). In 6 of the remaining chronic CSC patients, repeated SRT with higher pulse energy was considered because of persistent leakage activity. After the re-treatment, SRF resolved completely in 5 patients (83.3%) after only 25 days. Conclusion: SRT showed promising results in treating acute CSC, but was less effective in chronic cases. Interestingly, re-treatment resulted in enhanced fluid resolution and dry conditions after a considerably shorter time in most patients. Therefore, SRT including re-treatment if necessary might be a valuable CSC treatment alternative even in chronic-recurrent cases.

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Section: Discussionmentioning

confidence: 99%

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy

Framme¹,

Walter²,

Berger³

et al. 2015

Ophthalmologica

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“…1) [1,2]. Typische Symptome, die mit den morphologischen Veränderungen einhergehen, sind eine Sehverschlechterung mit Wahrnehmung eines (relativen) Skotoms im Zentrum des Gesichtsfeldes, Metamorphopsien oder Mikropsie [1,2,5].…”

Section: Transfer In Die Praxis Von Dr Maximilian Treder (Münster)unclassified

“…Neben den bekannten Risikofaktoren, wie ein typisches Patientenalter mit Gipfel um das 45. Lebensjahr, das männliche Geschlecht, Stress, Typ-A-Persönlichkeit und eine systemische Cortisonbehandlung, existieren viele weitere Faktoren, deren Einfluss auf die Entstehung einer RCS in der Literatur teils kontrovers diskutiert wird [1,2,5]. …”

Section: Transfer In Die Praxis Von Dr Maximilian Treder (Münster)unclassified

Einfluss der Jahreszeit auf das Auftreten einer Retinopathia centralis serosa

Treder¹

2019

Kompass Ophthalmol

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Purpose: We investigate seasonal variations found in patients with central serous chorioretinopathy (CSC). Methods: We retrospectively investigated 201 CSC patients at the Osaka Medical College Hospital from January 2011 to December 2016 and evaluated their seasonal and monthly distributions. Results: The study population comprised 149 males and 52 females. There were significant seasonal differences in the distribution of patients, with 62 cases in spring, 37 in summer, 59 in autumn, and 43 in winter, and the monthly prevalence of CSC was high in March (n = 24), April (n = 22), and November (n = 23). In addition, seasonal variation of serous retinal detachment (SRD) in the macula could be observed in 12 recurrent CSC cases. Conclusions: The prevalence of CSC development was the highest in spring. In addition, recurrent SRD in the macula showed seasonal variation in some CSC patients. As factors related to CSC, season and temperature might influence the pathophysiology of CSC.

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“…Dieses Histamin konnte in die Choriokapillaren gelangen und dort womöglich seine typischen Wirkungen entfalten: Weitung der Kapillaren und Erhöhung ihrer Permeabilität [5] [1]. Es ist bekannt, dass die Karboanhydrase IV (CA IV) in den Endothelzellen der Choriokapillaren vorhanden ist (nicht im Pigmentepithel) und gemeinsam mit dem "Na+/bicarbonat Co-transporter 1" (NBC1) eine Funktionseinheit bildet.…”

Section: üBerlegungen Zu äTiologie Und Therapieunclassified

Behandlung einer serösen makulären Netzhautablösung mit Antihistaminika

Kirschfeld

2014

Ophthalmologe

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Zusammenfassung Die Ätiologie der Netzhautablösungen bei Chorioretinopathia centralis serosa (CCS) ist unbekannt. Von 3 Tatbeständen wird aber ausgegangen: 1) dass der Abhebung der Rezeptor/Pigmentepithel-Schicht durch ein seröses Exsudat eine Hyperpermeabilität der Choriokapillaren zugrunde liegt; 2) dass betroffene Patienten häufig unter Kopfschmerzen leiden; 3) dass die Erkrankung durch Stress begünstigt wird. Eine erhöhte Histaminkonzentration im Blutplasma könnte zu den genannten Konsequenzen führen. Dies führte zur Hypothese, dass Histamin an der Entstehung der CCS beteiligt sein könnte. Nach Einnahme des Antihistaminikums Loratadin erfolgten innerhalb 1 Woche ein deutlicher Abbau des retinalen Exsudats sowie die Wiederherstellung des Sehvermögens. Dies stützt die Hypothese, dass Histamin an der Entstehung von Netzhautablösungen beteiligt sein könnte. Weitere Untersuchungen müssen klären, ob diese Hypothese zutrifft und ob Antihistaminika womöglich auch bei Makuladegeneration (AMD) eingesetzt werden können.

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Chorioretinopathia centralis serosa (CCS)

Cited by 20 publications

References 69 publications

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy

Einfluss der Jahreszeit auf das Auftreten einer Retinopathia centralis serosa

Behandlung einer serösen makulären Netzhautablösung mit Antihistaminika

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