Rationally select the timing and treatment method of central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

 Zhao Mingwei

Department of Ophthalmology, Peking University People′s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China;

Corresponding author：

Zhao Mingwei, Email: dr_zhaomingwei@163.com

Keywords：

Central serous chorioretinopathy; Laser photocoagulation; Subthreshold micropulse laser; Photodynamic therapy; Editorial

DOI：

10.3760/cma.j.cn511434-20230224-00088

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Central serous chorioretinopathy (CSC) is a common macular disease, mainly manifested as a plasma detachment of the macula. Photodynamic therapy (PDT) is an effective treatment for CSC, but with the shortage of the photosensitizer Verteporfin, the effective treatment of CSC has become a common concern for ophthalmologists. In this paper, based on the latest research results on the relationship between the changes in the thickness of the outer nuclear layer and the natural course of the disease and PDT therapy, we propose that patients with CSC should receive effective treatment as early as possible to prevent irreversible damage to visual function due to the thinning of the outer nuclear layer. In addition to PDT, it is recommended that laser photocoagulation or subthreshold micropulse laser treatment of the leaking spot should be considered first, depending on the presence of the leaking spot and its location in relation to the macula center. Anti-vascular endothelial growth factor therapy can be considered if there is a combination of choroidal neovascularization and/or polypoidal choroidal vasculopathy. Other treatments that have not been demonstrated to be effective in evidence-based medicine are not recommended.

Citation： Zhao Mingwei. Rationally select the timing and treatment method of central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2023, 39(4): 271-274. doi: 10.3760/cma.j.cn511434-20230224-00088 Copy

1.	Kido A, Miyake M, Tamura H, et al. Incidence of central serous chorioretinopathy (2011-2018): a nationwide population-based cohort study of Japan[J]. Br J Ophthalmol, 2022, 106(12): 1748-1753. DOI: 10.1136/bjophthalmol-2021-319403.
2.	Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
3.	Nicholson B, Noble J, Forooghian F, et al. Central serous chorioretinopathy: update on pathophysiology and treatment[J]. Surv Ophthalmol, 2013, 58(2): 103-126. DOI: 10.1016/j.survophthal.2012.07.004.
4.	Loo RH, Scott IU, Flynn HW, et al. Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy[J]. Retina, 2002, 22(1): 19-24. DOI: 10.1097/00006982-200202000-00004.
5.	Deng K, Gui Y, Cai Y, et al. Changes in the foveal outer nuclear layer of central serous chorioretinopathy patients over the disease course and their response to photodynamic therapy[J/OL]. Front Med (Lausanne), 2022, 14: 824239[2022-01-14]. https://europepmc.org/article/MED/35096914. DOI: 10.3389/fmed.2021.824239.
6.	Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3): 333-340. DOI: 10.1001/jamaophthalmol.2014.5312.
7.	Liang Z, Qu J, Huang L, et al. Comparison of the outcomes of photodynamic therapy for central serous chorioretinopathy with or without subfoveal fibrin[J]. Eye (Lond), 2021, 35(2): 418-424. DOI: 10.1038/s41433-020-0858-4.
8.	Gao T, Qu J, Xiao J, et al. Photodynamic therapy for bullous retinal detachment: a single-center experience of case series with a 6-month follow-up study[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(8): 1429-1439. DOI: 10.1007/s00417-018-4015-8.
9.	van Dijk EHC, Feenstra HMA, Bjerager J, et al. Comparative efficacy of treatments for chronic central serous chorioretinopathy: a systematic review with network meta-analyses[J]. Acta Ophthalmol, 2023, 101(2): 140-159. DOI: 10.1111/aos.15263.
10.	Chen SN, Hwang JF, Tseng LF, et al. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage[J]. Ophthalmology, 2008, 115(12): 2229-2234. DOI: 10.1016/j.ophtha.2008.08.026.
11.	Scholz P, Altay L, Fauser S. Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy[J]. Eye (Lond), 2016, 30(10): 1371-1377. DOI: 10.1038/eye.2016.142.
12.	Roca JA, Wu L, Fromow-Guerra J, et al. Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group[J]. Br J Ophthalmol, 2018, 102(12): 1696-1700. DOI: 10.1136/bjophthalmol-2017-311291.
13.	Wood EH, Karth PA, Sanislo SR, et al. Nondamaging retinal laser therapy for treatment of central serous chorioretinopathy: what is the Evidence?[J]. Retina, 2017, 37(6): 1021-1033. DOI: 10.1097/IAE.0000000000001386.
14.	van Dijk EHC, Fauser S, Breukink MB, et al. Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial[J]. Ophthalmology, 2018, 125(10): 1547-1555. DOI: 10.1016/j.ophtha.2018.04.021.
15.	van Rijssen TJ, van Dijk EHC, Scholz P, et al. Focal and diffuse chronic central serous chorioretinopathy treated with half-dose photodynamic therapy or subthreshold micropulse laser: PLACE trial report No. 3[J]. Am J Ophthalmol, 2019, 205: 1-10. DOI: 10.1016/j.ajo.2019.03.025.
16.	Bae SH, Heo J, Kim C, et al. Low-fluence photodynamic therapy versus ranibizumab for chronic central serous chorioretinopathy: one-year results of a randomized trial[J]. Ophthalmology, 2014, 121(2): 558-565. DOI: 10.1016/j.ophtha.2013.09.024.

1. Kido A, Miyake M, Tamura H, et al. Incidence of central serous chorioretinopathy (2011-2018): a nationwide population-based cohort study of Japan[J]. Br J Ophthalmol, 2022, 106(12): 1748-1753. DOI: 10.1136/bjophthalmol-2021-319403.
2. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
3. Nicholson B, Noble J, Forooghian F, et al. Central serous chorioretinopathy: update on pathophysiology and treatment[J]. Surv Ophthalmol, 2013, 58(2): 103-126. DOI: 10.1016/j.survophthal.2012.07.004.
4. Loo RH, Scott IU, Flynn HW, et al. Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy[J]. Retina, 2002, 22(1): 19-24. DOI: 10.1097/00006982-200202000-00004.
5. Deng K, Gui Y, Cai Y, et al. Changes in the foveal outer nuclear layer of central serous chorioretinopathy patients over the disease course and their response to photodynamic therapy[J/OL]. Front Med (Lausanne), 2022, 14: 824239[2022-01-14]. https://europepmc.org/article/MED/35096914. DOI: 10.3389/fmed.2021.824239.
6. Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3): 333-340. DOI: 10.1001/jamaophthalmol.2014.5312.
7. Liang Z, Qu J, Huang L, et al. Comparison of the outcomes of photodynamic therapy for central serous chorioretinopathy with or without subfoveal fibrin[J]. Eye (Lond), 2021, 35(2): 418-424. DOI: 10.1038/s41433-020-0858-4.
8. Gao T, Qu J, Xiao J, et al. Photodynamic therapy for bullous retinal detachment: a single-center experience of case series with a 6-month follow-up study[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(8): 1429-1439. DOI: 10.1007/s00417-018-4015-8.
9. van Dijk EHC, Feenstra HMA, Bjerager J, et al. Comparative efficacy of treatments for chronic central serous chorioretinopathy: a systematic review with network meta-analyses[J]. Acta Ophthalmol, 2023, 101(2): 140-159. DOI: 10.1111/aos.15263.
10. Chen SN, Hwang JF, Tseng LF, et al. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage[J]. Ophthalmology, 2008, 115(12): 2229-2234. DOI: 10.1016/j.ophtha.2008.08.026.
11. Scholz P, Altay L, Fauser S. Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy[J]. Eye (Lond), 2016, 30(10): 1371-1377. DOI: 10.1038/eye.2016.142.
12. Roca JA, Wu L, Fromow-Guerra J, et al. Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group[J]. Br J Ophthalmol, 2018, 102(12): 1696-1700. DOI: 10.1136/bjophthalmol-2017-311291.
13. Wood EH, Karth PA, Sanislo SR, et al. Nondamaging retinal laser therapy for treatment of central serous chorioretinopathy: what is the Evidence?[J]. Retina, 2017, 37(6): 1021-1033. DOI: 10.1097/IAE.0000000000001386.
14. van Dijk EHC, Fauser S, Breukink MB, et al. Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial[J]. Ophthalmology, 2018, 125(10): 1547-1555. DOI: 10.1016/j.ophtha.2018.04.021.
15. van Rijssen TJ, van Dijk EHC, Scholz P, et al. Focal and diffuse chronic central serous chorioretinopathy treated with half-dose photodynamic therapy or subthreshold micropulse laser: PLACE trial report No. 3[J]. Am J Ophthalmol, 2019, 205: 1-10. DOI: 10.1016/j.ajo.2019.03.025.
16. Bae SH, Heo J, Kim C, et al. Low-fluence photodynamic therapy versus ranibizumab for chronic central serous chorioretinopathy: one-year results of a randomized trial[J]. Ophthalmology, 2014, 121(2): 558-565. DOI: 10.1016/j.ophtha.2013.09.024.

Next Article
Efficacy of optical coherence tomography angiography guided half-dose photodynamic therapy in the treatment of acute central serous chorioretinopathy

Chinese Journal of Ocular Fundus Diseases

Rationally select the timing and treatment method of central serous chorioretinopathy

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content