The Natural History of Pigment Epithelial Detachment Associated With Central Serous Chorioretinopathy

Ss, Mudvari; Mj, Goff; Ad, Fu; Hr, McDonald; Rn, Johnson; E, Ai; Jm, Jumper

doi:10.1097/iae.0b013e318156db8a

Cited by 77 publications

(54 citation statements)

References 29 publications

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“…[1][2][3][15][16][17][18][19][20][21] In a retrospective study, Mudvari et al 29 found that none of the 340 consecutive CSCR patients developed CNV during an approximate 4-year follow-up period (mean of 49 months). However, Spaide et al 30 reported that older patients with CSCR had a lower VA, and were more likely to have diffuse retinal pigment epitheliopathy and secondary CNV than their younger counterparts.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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Purpose To evaluate the results of indocyanine green angiography (ICGA)-guided verteporfin photodynamic therapy (PDT) with half-fluence rate combined with intravitreal application of anti-VEGF in treating choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSCR). Patients and methods In this retrospective cohort study 17 consecutive patients with secondary CNV due to chronic CSCR had their diagnosis verified with fluorescein angiography (FA) and ICGA at baseline. All eyes received either intravitreal ranibizumab (IVR) or bevacizumab (IVB). On the consecutive day following the initial IVR/IVB treatment, ICGAguided verteporfin (6 mg/m 2 ) PDT with halffluence rate (25 J/cm 2 ) was performed on every patient. IVR or IVB was rescheduled on a pro re nata regimen. Main outcome measures were changes in visual acuity (VA) according to the ETDRS letter score and changes in the central foveal thickness (CFT). Results Best-corrected VA at baseline was 65.6 letters (±6.7; n = 17) according to the ETDRS letter score. At 12 months, mean ETDRS letter score improved to 71.2 letters (P = 0.34). CFT was 309 μm and decreased to 216 μm at month 12 control (P = 0.0004). Nine eyes (52.9%) received additional treatment with IVR/IVB due to recurrence of subretinal fluid, with an overall mean number of IVR/IVB treatment of 1.8 ± 3.6 per patient with no systemic side effects during 12 months' follow-up. Conclusions IVR or IVB combined with ICGA-guided half-fluence PDT with verteporfin is effective in treating CNV in chronic CSCR, with choroidal hyperpermeability in ICGA, resulting in stable vision and significant reduction of CFT.

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Section: Discussionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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“…There are three theories on CSC pathogenesis: [1][2][3][4][5] (1) Disorder of the outer BRB, which leads to choroidal vascular hyperpermeability. 22 (2) Dysfunction of the RPE with a reversal of liquid transport.…”

Section: Discussionmentioning

confidence: 99%

“…2 CSC may be associated with extraocular conditions, including type A personality, organ transplantation, use of steroids, systemic lupus erythematous, Cushing's disease, and other systemic factors. [3][4][5][6] Blurred vision is perceived typically by patients as a dark spot in the center of the visual field with associated hyperopic shift, micropsia, and metamorphopsia, caused by anterior displacement of the retinal plane because of porous RPE. Typically, CSC resolves spontaneously within 3 months in more than 50% of patients, with recovery of visual acuity (VA) despite some pigment epithelium scarring.…”

Section: Introductionmentioning

confidence: 99%

Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy

Koss

Beger

Koch

2011

Eye

101

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Purpose To evaluate the treatment of central serous chorioretinopathy (CSC) with either subthreshold diode laser MicroPulse (SDM) or intravitreal bevacizumab (BCZ). Methods This comparative, controlled, prospective study conducted over a period of 10 months examined 52 eyes of 52 patients with (a) treatment with SDM at the active leakage site guided by fluorescein angiography (FA) (n ¼ 16 eyes), (b) intravitreal injection of 1.25 mg BCZ (n ¼ 10 eyes), or (c) observation (n ¼ 26 eyes). Outcome measures included changes in retinal pigment epithelium (RPE) leakage at FA, central macular thickness (CMT), best-corrected visual acuity (BCVA), and 101 macular perimetry. Results At the end of the study, there was 12.5% persistent leakage in the SDM, compared with 60% in the BCZ and 92% in the control group. Mean CMT decreased by 94 lm in the SDM, 38 lm in the BCZ, and did not change in the control group. Mean BCVA improved more than 6 early treatment of diabetic retinopathy study letters in the SDM, decreased by one letter in the BCZ, and by two letters in the control group. In the SDM group, mean perimetric deficit improved by 1.5 decibels and corrected lost variance by 2.6. In the BCZ, it improved by 0.6, and in the control group by 0.5. Retreatment was required in 7/16 eyes of the SDM group (43.75%), and in 5/10 eyes of the BCZ group (50%). Conclusion SDM photocoagulation was superior to intravitreal injections of 1.25 mg BCZ in the treatment of CSC, which resulted in enhanced visual acuity and macular perimetry.

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“…Retinal pigment epithelial detachment (PED) is a recognised associated finding, reported to occur in 9–27.1% of cases in two large series [1,2]. The PED can either occur in isolation or may coexist with a neurosensory retinal elevation, and this finding can be associated with a poor visual prognosis especially when the PED is present in a subfoveal location or becomes persistent.…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Therapy for Variant Central Serous Chorioretinopathy: Efficacy and Side Effects

Gupta

Mohamed²

2011

Ophthalmologica

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Background: Retinal pigment epithelial detachment (PED) is a recognised associated finding in central serous chorioretinopathy (CSC). We report our experience in treating patients using photodynamic therapy (PDT) in a variant of chronic CSC that presents with only an isolated PED. We present long-term follow-up data and novel observations on the pattern of retinal pigment epithelium (RPE) changes seen after treatment. Methods: Retrospective case series. Results and Discussion: CSC with subfoveal PED can be associated with a poor visual prognosis especially when the PED becomes chronic. PDT has been used to treat typical CSC with good outcomes. Three eyes in 3 patients were successfully treated with PDT, using the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy protocol. However, marked RPE disturbance was observed after treatment directly overlying the areas of brisk choroidal hyperpermeability.

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The Natural History of Pigment Epithelial Detachment Associated With Central Serous Chorioretinopathy

Abstract: CSC with associated retinal PED may be seen and generally has a good visual prognosis. The most frequent outcome is resolution with retinal pigment epithelial atrophy. Subfoveal PED occurs less commonly and may have a poorer visual prognosis.

Cited by 77 publications

References 29 publications

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy

Photodynamic Therapy for Variant Central Serous Chorioretinopathy: Efficacy and Side Effects

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