Treatment of Central Serous Chorioretinopathy (Csc) Using Diclofenac through Different Routes of Administration, a Comparative Study

Abstract

Purpose: To evaluate the effect of diclofenac nonsteroidal antiinflammatory drug (NSAID) in the treatment of acute central serous chorioretinopathy (CSC) by different routes of administration and compare the results with control patients. Introduction:Central serous chorioretinopathy (CSC) is an idiopathic disorder characterized by a serous detachment of the neurosensory retina at the macula, which is caused by active retinal pigment epithelial (RPE) leakage. Although the exact pathophysiology of CSC has not been clearly elucidated, the primary abnormality leading to RPE disruption and leakage is thought to be increased choroidal permeability. Studies using different imaging techniques have revealed the possible causes of abnormal permeability of the inner choroid. Ischemia and inflammation might lead to exudative changes within the choroid and the subsequent changes at the RPE. Topical diclofenac, ketorolac, nepafenac and bromfenac all belong to the NSAIDs class of medications. As an anti-inflammatory class, they function by inhibiting the enzyme cyclooxygenase, which blocks the synthesis of prostaglandins. A reduction in prostaglandin formation results a decrease in inflammation. It appears that the principle pathway involved in pain and inflammation is the COX-2 pathway where nonsteroidal anti-inflammatory drugs (NSAIDs) seems to play a significant role.

Central Serous Chorioretinopathy Associated with Calcium Channel Blocker Consumption: A Case Report

“…11 Patient was first treated with topical and oral NSAID which works by decreasing prostaglandin production by inhibit the production of cyclooxygen enzyme (COX), an agent responsible for vasodilatation and increasing blood vessel permeability. A study conducted by Khan et al 21 found that the use of topical NSAID improved CMT and visual acuity up to 30 th day after treatment. However, in our case, patient's condition did not improve after NSAID administration.…”