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Fung AT, Yang Y, Kam AW. Central serous chorioretinopathy: A review. Clin Exp Ophthalmol 2023; 51:243-270. [PMID: 36597282 DOI: 10.1111/ceo.14201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023]
Abstract
Central serous chorioretinopathy (CSC) is the fourth most common non-surgical 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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Affiliation(s)
- Adrian T Fung
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Yi Yang
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Andrew W Kam
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
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Kim YW, Lee KW, Ahn JH, Nam DH, Lee DY. Clinical Effects of Non-damaging Retinal Laser Therapy in Chronic Central Serous Chorioretinopathy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.2.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Chung SR, Jeong JG, Lee TE, You IC, Ahn M, Cho NC. Oral Spironolactone Treatment in Chronic Central Serous Chorioretinopathy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.3.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sae Rom Chung
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jin Gu Jeong
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
| | - Tae Eun Lee
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - In Cheon You
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - Min Ahn
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - Nam Chun Cho
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
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Shin YI, Kim KM, Lee MW, Kim JY, Jo YJ. Long-term results of focal laser photocoagulation and photodynamic therapy for the treatment of central serous chorioretinopathy. Jpn J Ophthalmol 2019; 64:28-36. [PMID: 31863228 DOI: 10.1007/s10384-019-00697-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the long-term results of focal laser photocoagulation and photodynamic therapy (PDT) for treatment of central serous chorioretinopathy (CSC). STUDY DESIGN Retrospective chart review. METHODS Sixty-two patients with CSC, thirty-three of whom were treated with focal laser photocoagulation, and 29 with PDT and who were followed up for > 6 months, were enrolled. The focal laser was performed at sites of focal leakage (but not subfoveal leaks) shown in fluorescein angiography. PDT was performed at sites of subfoveal or juxtafoveal focal leakage or not definite focal leakages. Best corrected visual acuity (BCVA), central macular thickness (CMT), resolution of subretinal fluid (SRF) and recurrence were analyzed. RESULTS The follow-up duration of the focal laser group was 35.2 ± 22.6 and of the PDT group, 46.4 ± 21.5 months. Time to resolution of SRF was 1.8 ± 1.5 months for the focal laser group and 1.2 ± 0.5 months for the PDT group. SRF was rapidly absorbed in the PDT group. In both groups, the CMT was decreased 1 month after treatment. The BCVA improved significantly 1 month after treatment in the focal laser group and 3 months after treatment in the PDT group. However, there was no significant difference in CMT reduction and BCVA improvement between the two groups. It subsequently remained similar for up to 3 years. Ten patients (30.3%) in the focal laser group and three patients (10%) in the PDT group recurred during the follow-up period. CONCLUSIONS PDT showed early resolution of the SRF compared to focal laser. In CSC patients, both the CMT and BCVA remained stable for 3 years after treatment. After 3 or more years of follow-up, PDT showed a lower recurrence rate than focal laser.
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Affiliation(s)
- Yong-Il Shin
- Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Kyeung-Min Kim
- Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Min-Woo Lee
- Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Young-Joon Jo
- Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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Lee JY, Kim DY, Lee EK, Lee SY, Lee HJ, Jeong JH, Kim JY. Comparison of Short-term Clinical Outcomes between Oral Spironolactone and Observation in Acute Central Serous Chorioretinopathy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.6.511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Young Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
| | - Dong Yoon Kim
- Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Ophthalmology, Chungbuk National University Hospital, Cheongju, Korea
| | - Eun Kyoung Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
| | - Sang-Yoon Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
| | - Hye Jin Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
| | - Jin Ho Jeong
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
| | - Jin Young Kim
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
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