Update on the management of chronic central serous chorioretinopathy

Moreno-Morillo, Francisco Javier; Fernández-Vigo, J.I.; Güemes-Villahoz, Noemí; Burgos-Blasco, Bárbara; López-Guajardo, Lorenzo; Donate-López, J.

doi:10.1016/j.oftale.2020.07.005

Cited by 4 publications

(11 citation statements)

References 76 publications

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“…This causes production of free radicals that induce inflammation, apoptosis, microthrombosis and occlusion of the abnormal choroidal vessels. This inflammatory process and subsequent vascular remodelling is thought to reduce choroidal hyperpermeability and SRF leakage 131 . Although generally considered safe, it is contraindicated in patients with porphyria, systemic lupus erythematosus, photosensitive dermatoses and allergy to verteporfin.…”

Section: Managementmentioning

confidence: 99%

Central serous chorioretinopathy: A review

Fung

Yang

Kam

2023

Clinical Exper Ophthalmology

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Central serous chorioretinopathy (CSC) is the fourth most common nonsurgical retinopathy associated with fluid leakage. The pathogenesis is not yet completely understood, but changes in the choroid, sclera and RPE have been described associated with venous congestion of choroidal outflow. CSC can be categorised into acute, chronic, and recurrent subtypes with recent classifications of simple and complex based on the area of RPE change seen on fundus autofluorescence. A multimodal imaging approach is helpful in the diagnosis and management of CSC and secondary complications such as type 1 neovascularisation. Although spontaneous resolution with relatively good visual outcomes is common, treatment should be considered in patients with persistent or recurrent SRF. Treatment options include laser, systemic medications, intravitreal therapy, and surgery. Of these, argon laser for focal extramacular fluid leaks and photodynamic therapy of leakage identified by indocyanine-green angiography currently have the greatest supportive evidence.

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Section: Managementmentioning

confidence: 99%

Central serous chorioretinopathy: A review

Fung

Yang

Kam

2023

Clinical Exper Ophthalmology

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“…Fluorescein angiograph (FA)-based focal thermal laser photocoagulation to the leak has been the cornerstone of treatment of nonrevolving CSCR. [ 1 ] However, thermal laser photocoagulation is not suitable for treatment of subfoveal leak, for which photodynamic therapy with verteporfin has been the treatment of choice. [ 1 2 ] In view of ongoing unavailability of photodynamic therapy, the role of subthreshold micropulse laser in management of CSCR seems more pertinent than ever.…”

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confidence: 99%

“…[ 1 ] However, thermal laser photocoagulation is not suitable for treatment of subfoveal leak, for which photodynamic therapy with verteporfin has been the treatment of choice. [ 1 2 ] In view of ongoing unavailability of photodynamic therapy, the role of subthreshold micropulse laser in management of CSCR seems more pertinent than ever. It uses a grid pattern of laser spots to treat the FA-guided leakage point.…”

mentioning

confidence: 99%

“…Lack of treatment endpoint in the form of visible retinal burn has been suggested as a reason for undertreatment and nonresponse to this treatment modality. [ 1 ] There are no standard parameters of subthreshold micropulse yellow laser for treatment of CSCR. Various studies have used duty cycles ranging from 5% to 15% with spot size of 100–200 mm and power of 90–1800 mW.…”

mentioning

confidence: 99%

“…Various studies have used duty cycles ranging from 5% to 15% with spot size of 100–200 mm and power of 90–1800 mW. [ 1 ] Hence, the present study is a step in the right direction as it attempts to compare two different duty cycles of yellow laser. [ 5 ] It has found similar visual acuity gains and central macular thickness reduction with 5% and 10% duty cycles of yellow laser.…”

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confidence: 99%

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Commentary: Subthreshold micropulse yellow laser for central serous chorioretinopathy: Finding the right protocol

Saurabh¹,

Roy

Biswas³

et al. 2022

Indian Journal of Ophthalmology

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Quantitative autofluorescence in central serous chorioretinopathy

Weber,

Schaetzle,

Stasik

et al. 2023

Retina

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Introduction: Central serous chorioretinopathy (CSC) is associated with pachychoroid and dysfunctional RPE. Autofluorescence (AF) is typically altered. We performed this study to quantify these alterations using quantitative AF (qAF) in patients with CSC and in their fellow-eye in comparison with a healthy control group. Material and Methods: Patients with CSC and healthy patients were recruited prospectively. All patients received a full clinical examination including best corrected visual acuity (BCVA), enhanced depth imaging-OCT and qAF. QAF images were taken with a confocal scanning laser ophthalmoscope (Heidelberg Engineering). QAF values were assessed in specified regions of the inner eight (IN8) and the middle ring (MID) of the Delori-grid. Results: 141 eyes of 77 patients with CSC were included. 90 eyes had a manifest CSC (group 1) while 51 fellow-eyes (group 2) did not show signs of CSC. There were no significant differences of qAF values between these two groups: mean qAF values were 241.3 (IN8) and 212.8 (MID) in group 1 and 235.9 (IN8) and 210.0 (MID) in group 2 (p=1.0 and 1.0). We compared these eyes to healthy controls comprising 39 eyes. QAF signals (IN8: 164.7; MID:148.9) differed significantly compared to both CSC manifest (p<0.001) and fellow eyes (p<0.001). Conclusions: Our results show that patients with CSC have increased qAF values in both eyes with manifest CSC and asymptomatic, clinically unremarkable fellow-eyes in comparison to healthy controls. This finding suggests that qAF alterations are present even before clinical signs can be observedand might therefore serve as an early biomarker.

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Update on the management of chronic central serous chorioretinopathy

Cited by 4 publications

References 76 publications

Central serous chorioretinopathy: A review

Central serous chorioretinopathy: A review

Commentary: Subthreshold micropulse yellow laser for central serous chorioretinopathy: Finding the right protocol

Quantitative autofluorescence in central serous chorioretinopathy

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