TY - JOUR

T1 - Central serous chorioretinopathy

T2 - Towards an evidence-based treatment guideline

AU - van Rijssen, Thomas J.

AU - van Dijk, Elon H.C.

AU - Yzer, Suzanne

AU - Ohno-Matsui, Kyoko

AU - Keunen, Jan E.E.

AU - Schlingemann, Reinier O.

AU - Sivaprasad, Sobha

AU - Querques, Giuseppe

AU - Downes, Susan M.

AU - Fauser, Sascha

AU - Hoyng, Carel B.

AU - Piccolino, Felice Cardillo

AU - Chhablani, Jay K.

AU - Lai, Timothy Y.Y.

AU - Lotery, Andrew J.

AU - Larsen, Michael

AU - Holz, Frank G.

AU - Freund, K. Bailey

AU - Yannuzzi, Lawrence A.

AU - Boon, Camiel J.F.

PY - 2019/11

Y1 - 2019/11

N2 - Central serous chorioretinopathy (CSC) is a common cause of central vision loss, primarily affecting men 20–60 years of age. To date, no consensus has been reached regarding the classification of CSC, and a wide variety of interventions have been proposed, reflecting the controversy associated with treating this disease. The recent publication of appropriately powered randomised controlled trials such as the PLACE trial, as well as large retrospective, non-randomised treatment studies regarding the treatment of CSC suggest the feasibility of a more evidence-based approach when considering treatment options. The aim of this review is to provide a comprehensive overview of the current rationale and evidence with respect to the variety of interventions available for treating CSC, including pharmacology, laser treatment, and photodynamic therapy. In addition, we describe the complexity of CSC, the challenges associated with treating CSC, and currently ongoing studies. Many treatment strategies such as photodynamic therapy using verteporfin, oral mineralocorticoid antagonists, and micropulse laser treatment have been reported as being effective. Currently, however, the available evidence suggests that half-dose (or half-fluence) photodynamic therapy should be the treatment of choice in chronic CSC, whereas observation may be the preferred approach in acute CSC. Nevertheless, exceptions can be considered based upon patient-specific characteristics.

AB - Central serous chorioretinopathy (CSC) is a common cause of central vision loss, primarily affecting men 20–60 years of age. To date, no consensus has been reached regarding the classification of CSC, and a wide variety of interventions have been proposed, reflecting the controversy associated with treating this disease. The recent publication of appropriately powered randomised controlled trials such as the PLACE trial, as well as large retrospective, non-randomised treatment studies regarding the treatment of CSC suggest the feasibility of a more evidence-based approach when considering treatment options. The aim of this review is to provide a comprehensive overview of the current rationale and evidence with respect to the variety of interventions available for treating CSC, including pharmacology, laser treatment, and photodynamic therapy. In addition, we describe the complexity of CSC, the challenges associated with treating CSC, and currently ongoing studies. Many treatment strategies such as photodynamic therapy using verteporfin, oral mineralocorticoid antagonists, and micropulse laser treatment have been reported as being effective. Currently, however, the available evidence suggests that half-dose (or half-fluence) photodynamic therapy should be the treatment of choice in chronic CSC, whereas observation may be the preferred approach in acute CSC. Nevertheless, exceptions can be considered based upon patient-specific characteristics.

KW - Central serous chorioretinopathy

KW - Guideline

KW - Micropulse laser

KW - Mineralocorticoid antagonist

KW - Photodynamic therapy

KW - Retina

KW - Treatment

U2 - 10.1016/j.preteyeres.2019.07.003

DO - 10.1016/j.preteyeres.2019.07.003

M3 - Review

C2 - 31319157

AN - SCOPUS:85069976062

VL - 73

JO - Progress in Retinal and Eye Research

JF - Progress in Retinal and Eye Research

SN - 1350-9462

M1 - 100770

ER -