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 -