Acute Central Serous Chorioretinopathy Research Articles

Choroidal Vascularity Index versus Choroidal Thickness as Biomarkers of Acute Central Serous Chorioretinopathy

Introduction: The aim of this study was to analyze the choroidal vascularity index (CVI) versus choroidal thickness (CT) as biomarkers in acute central serous chorioretinopathy (CSCR). Methods: In this multicenter retrospective, cross-sectional, noninterventional study carried out at Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain; Jules-Gonin, Lausanne, Switzerland; and Pittsburg University, USA. 40 eyes from 40 patients with acute CSCR, 40 eyes from 40 patients with keratoconus (KC), and 40 eyes from 40 healthy patients were included. The variables analyzed were age, CT, CVI, and the presence of neurosensory retinal detachment. CT and the CVI were obtained from a 12-mm horizontal single-line B-scan (Triton SS-OCT, Topcon Co., Japan). Blinded measurements of the subfoveal CT were performed manually by two independent investigators. The images of the choroid were automatically binarized using a validated algorithm, and a percentage of vascularity was calculated. Results: There were no significant differences in age between the three groups (ANOVA, p = 0.092). There were statistically significant differences in CT and the CVI (ANOVA, p < 0.001). After Bonferroni correction, pairwise analysis between CSCR group against the KC group showed no significant differences in age and CT (p = 0.10 and p = 0.27, respectively). CVI was statistically greater among CSCR patients (p = 0.03). Conclusion: CT does not meet the criteria to be considered a biomarker of acute CSCR, while CVI may prove to be a more specific and reliable biomarker. Further studies with larger sample sizes, standardized procedures, and a wider representation of all CSCR stages are necessary to confirm the validity of CVI as biomarker in this disease. Further studies with larger samples are required in order to validate the use of CVI/CT correlation as a new biomarker.

Acute central serous chorioretinopathy following topical minoxidil use for androgenic alopecia - A case report

Acute central serous chorioretinopathy following topical minoxidil use for androgenic alopecia - A case report

Селективная микроимпульсная индивидуальная ретинальная терапия при навигационном лечении центральной серозной хориоретинопатии с подбором параметров путем предварительного тестирования

Aim: to evaluate the outcomes of selective micropulse individual retinal therapy (SMIRT) in navigation-guided treatment for central serous chorioretinopathy (CSCR) by selecting parameters by preliminary testing. Patients and Methods: 61 patients (61 eyes) aged 36–58 with acute CSCR and transparent media were enrolled. The patients were divided into two groups. In the study group (31 eyes), CSCR treatment was performed using SMIRT technology and Laser system. Micropulse mode was applied. According to the computer simulation, this mode implies selective destruction of the retinal pigment epithelium with minimal damage to the neurosensory retina and choroid. Parameters were customized for each patient by preliminary testing and evaluation of the results by short-wavelength fundus autofluorescence (488 nm). Laser spots were applied close to each other to completely cover the leakage points revealed by fluorescein angiography. Control group patients (30 eyes) did not receive laser treatment. Follow-up examinations were performed 1, 3, 6, and 12 months after enrollment. Results: after one year, complete resorption of subretinal fluid was reported in all eyes in the study group and 10 eyes (33.3%) in the control group. In the study group, the best-corrected visual acuity (BCVA) increased from 0.85±0.02 to 0.98±0.02 (p&lt;10-8), while central photosensitivity increased from 24.34±0.33 to 29.15±0.17 dB (p&lt;6×10-6). In the control group, BCVA decreased from 0.84±0.02 to 0.77±0.03, while photosensitivity slightly increased from 25.09±0.32 to 25.32±0.72 dB. Conclusion: navigation-guided treatment for CSCR using the SMIRT technology with selecting parameters by preliminary testing has demonstrated high efficacy and safety. This tool can be used when leakage points are located in the fovea. KEYWORDS: selective micropulse individual retinal therapy (SMIRT), central serous chorioretinopathy, micropulse, navigation, customized approach. FOR CITATION: Volodin P.L., Ivanova E.V. Selective micropulse individual retinal therapy in the navigation-guided treatment for central serous chorioretinopathy with parameter selection by preliminary testing. Russian Journal of Clinical Ophthalmology. 2023;23(3):112–118 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-1.

Retinal pigment epithelium tear in an idiopathic acute onset bullous central serous chorioretinopathy

Although retinal pigment epithelium (RPE) tears are common in patients with chronic conditions such as exudative age-related macular degeneration or may occur in response to anti-vascular endothelial growth factor or laser treatment, a spontaneous RPE tear can occur in patients with acute and new-onset bullous central serous chorioretinopathy (CSCR). We present a rare case of a healthy young Asian man with unilateral massive subretinal fluid (SRF). An idiopathic acute-onset bullous CSCR with an RPE tear was diagnosed through ancillary examinations. This patient exhibited good visual recovery as indicated by foveal sparing, spontaneous resolution of SRF, and the lack of a need for unnecessary surgery.

A case of acute central serous chorioretinopathy after immunization with covid-19 mrna vaccine

A case of acute central serous chorioretinopathy after immunization with covid-19 mrna vaccine

Reply to Letter to Editor: Unilateral Acute Central Serous Chorioretinopathy with Inactivated Coronavirus Disease 2019 Vaccination - A Case Report and Review of Literature.

Reply to Letter to Editor: Unilateral Acute Central Serous Chorioretinopathy with Inactivated Coronavirus Disease 2019 Vaccination - A Case Report and Review of Literature.

Letter to Editor: Unilateral Acute Central Serous Chorioretinopathy with Inactivated Coronavirus Disease 2019 Vaccination: A Case Report and Review of Literature.

Letter to Editor: Unilateral Acute Central Serous Chorioretinopathy with Inactivated Coronavirus Disease 2019 Vaccination: A Case Report and Review of Literature.

Subthreshold micropulse 532-nm green laser treatment of acute central serous chorioretinopathy: 18-month results

Purpose The aim of this study was to evaluate the efficacy and safety of 532-nm green subthreshold micropulse laser (GSML) as a treatment for acute central serous chorioretinopathy (CSCR). Patients and methods This was a prospective study that included 42 eyes of 42 patients with acute CSCR treated with IRIDEX IQ 532-nm GSML. The study was conducted at Minia University Hospital and Genaidy Ophthalmology Center, Minia, Egypt, between October 2019 and May 2022. All patients were subjected to complete ophthalmological examination, fluorescein angiography, and optical coherence tomography at baseline and each follow-up visit at 1, 3, and 18 months after laser treatment. The outcome measures included the change in best-corrected visual acuity from baseline, optical coherence tomography-measured central macular thickness, as well as the resolution of subretinal fluid (SRF). Results The mean baseline LogMAR best-corrected visual acuity was 0.41±0.27 and significantly improved to 0.29±0.17 at 1 month (P=0.001), 0.21±0.14 at 3 months (P=0.0001), and 0.16±0.12 at 18 months (P=0.0001). The mean central macular thickness was 438.8±141.9 μm before treatment with a significant reduction to 352.8±60.6 μm after 1 month (P=0.005), 291.1±55.3 μm after 3 months (P=0.0001), and 241.8±24.5 μm after 18 months (P=0.0001). Regarding the SRF, it was absent in 40 (95.2%) eyes at the 3-month visit, whereas recurrence was present in only two (4.8%) eyes, with no cases of persistent SRF at the last follow-up. No complications were encountered during or after laser treatment. Conclusions GSML may be a safe and effective treatment modality for the acute form of CSCR with a low rate of disease recurrence.

Functionality of retinal vessels in central serous retinopathy: A comparison between eplerenone and photodynamic therapy.

To investigate retinal vessels functionality in patients with acute central serous chorioretinopathy (CSC) undergoing oral eplerenone or photodynamic therapy (PDT) using Retinal Vessel Analyzer (RVA) and Dynamic Vessel Analyzer (DVA), respectively. Treatment naïve acute CSC patients presenting between May 2017 and June 2017 were recruited. A complete ophthalmological examination was performed in all participants before and after oral eplerenone (eplerenone group) or half-dose PDT (PDT group). Eighteen eyes of 18 patients affected by acute CSC underwent either oral eplerenone (10 eyes of 10 patients, 47.6 ± 8.9 years old) or half-dose PDT (8 eyes of 8 patients, 57.4 ± 6.2 years old), respectively. After 2 months of treatment, non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were reported in eplerenone group. Similarly, in PDT group non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were found after 2 months of treatment. Static and dynamic retinal functionalities in acute CSC may not be significantly improved by oral eplerenone and half-dose PDT. Although their choroidal effects, these treatments could not exert a significant effect on retinal vessels motility. Thus, both local and systemic therapies might not help avoiding the onset of vascular and other retinal known alterations of CSC.

Ganglion Cell Loss in the Course of Central Serous Chorioretinopathy.

Central serous chorioretinopathy (CSCR) as a clinical entity is potentially damaging and may significantly affect retinal morphology and function, especially in the chronic form. Our study aimed to determine the amount of deficit of best corrected visual acuity (BCVA) and individual retinal layers, including ganglion cells, in different types of CSCR and with reference to its duration. The retrospective analysis included 69 eyes of patients with resolved CSCR managed in Dobry Wzrok Ophthalmological Clinic between 1 January 2019 and 30 June 2022. The diagnosis of CSCR was based on the criteria outlined by the Central Serous Chorioretinopathy International Group. The analysis included data obtained from medical history, BCVA testing, and spectral domain optical coherence tomography (SD-OCT) measurements, with specific thickness values for individual retinal layers. The results were compared among affected eyes, unaffected fellow eyes, and healthy controls. BCVA values were significantly lower in acute (0.08 ± 0.12 logMAR) and chronic (0.26 ± 0.19 logMAR) cases versus controls (0.0 logMAR). The thickness of all retinal layers (central subfoveal thickness, CST; inner retina with ganglion cell complex, GC; outer retina, ORT; and photoreceptor outer segments, POS) and macular volume (MV) were significantly decreased in chronic eyes versus controls (p < 0.01). Acute eyes had significant thinning of the outer retina and POS only compared to control eyes (p < 0.01). The amount of deficit in CST, ORT, GC, and MV was strongly correlated with poorer BCVA (p < 0.001), and the deficit of CST, ORT, and GC was correlated with disease duration (p < 0.05). The subfoveal choroidal thickness was significantly greater in affected and fellow eyes versus controls (p < 0.001). Damage to the outer retina and photoreceptors occurs early in the course of CSCR, with a deficit in ganglion cells noted adjunctively in chronic forms of the disease. Further studies are required to precisely determine correlation between visual loss in CSCR and deficits in individual retinal layers.

Influence of complex application of heliox therapy and acupuncture on maximally corrected visual acuity in patients with acute form of central serous chorioretinopathy

BACKGROUND: Central serous chorioretinopathy is a socially significant problem, as it is one of the most common diseases of the retina. It is more common in males of working age.&#x0D; AIM: to evaluate the effect of the combined use of heliox therapy and acupuncture on the most corrected visual acuity in patients with acute central serous chorioretinopathy.&#x0D; MATERIAL AND METHODS: The study included 34 men (34 eyes) with central serous chorioretinopathy, whose mean age was 362.3 years. The patients were divided into 2 groups comparable according to clinical and laboratory data: the main one ― 22 people, average age 323.1 years, who in the first two weeks received a complex of physiotherapeutic treatment, including: heliox 21, for a course of 10 daily procedures and acupuncture, also for a course of 10 daily procedures, and a control ― 12 people, average age 341.5 years, who, after consulting a neurologist, were prescribed medication (light sedatives, the Nutrof vitamin complex, diuretics 1 time in 3 days with restoration of electrolyte balance, alcohol restriction), which served as a background in the main group.&#x0D; Visometry (visual acuity) was used to assess the effectiveness of treatment. Before treatment, after 2 weeks, after 1 month, 3 months, 6 months, 12 months.&#x0D; RESULTS: Before treatment in patients with acute central serous chorioretinopathy, the maximum corrected visual acuity was reduced by 44.2% compared to the norm ― 0.950.05 (p 0.001) and comparable in the main group 0.540.05 and in the control group 0.530.05 (p=0.901). The maximum increase in visual acuity in patients of the main group was already two weeks later, with a subsequent increase in the indicator during the year, approaching the normal values at the last observation point (1 year). In addition, all patients after treatment noted a decrease in the intensity or exclusion of metamorphopsia. In the maximally corrected visual acuity control group, significantly less significant results were obtained at all control points.&#x0D; CONCLUSION: Under the influence of the combined use of heliox therapy and acupuncture in patients with acute form of central serous chorioretinopathy, a more pronounced and persistent increase in maximally corrected visual acuity occurred compared to drug treatment.

Natural Course of Pachychoroid Pigment Epitheliopathy.

To investigate the natural course of pachychoroid pigment epitheliopathy (PPE). A retrospective cohort study. From the Kyoto central serous chorioretinopathy (CSC) cohort consisting of 548 patients with CSC as of September 2020, we included consecutive unilateral patients with acute or chronic CSC between January 2013 and December2016. All patients underwent complete ophthalmic examination, including multimodal imaging such as fundus autofluorescence, spectral-domain optical coherence tomography, and fluorescein angiography/indocyanine green angiography and/or optimal coherence tomography angiography. The fellow eyes of eyes diagnosed with CSC were screened for PPE, and their natural course was evaluated. We also evaluated the association of ARMS2 rs10490924, CFH rs800292, TNFRSF10A rs13278062, and GATA5 rs6061548 genotypes with the natural course. Incidence of CSC, pachychoroid neovasculopathy, and pachychoroid geographic atrophy (GA). In total, 165 patients with unilateral CSC (mean age, 55.7±12.6 years; female, 22.4%) were included from the Kyoto CSC cohort. Among them, 148 (89.7%) were diagnosed as having PPE in their non-CSC eye. Survival analysis revealed that 16.8% of PPE eyes developed CSC during the 6-year follow up, whereas non-PPE eyes did not. Although genetic factors did not have significant association with CSC development (P>0.05, log-rank test), choroidal vascular hyperpermeability (CVH) and subfoveal choroidal thickness (SFCT) were significantly associated with CSC incidence (P=0.001, log-rank test). Survival analysis showed that eyes without CVH and eyes with SFCT < 300 μm did not develop CSC during the 6-year follow-up. Pachychoroid neovasculopathy developed in only 1 eye with PPE during a follow-up of 46.4 months. Pachychoroid GA did not develop in any of the studied eyes. This study revealed a natural history of PPE in a relatively large Japanese cohort. Choroidal vascular hyperpermeability and SFCT were significant risk factors for the development of CSC in PPE eyes. Although the current results cannot be generalized for all eyes with PPE, these findings present an important clinical implication.

Cortisol awake response imbalance as an indicator of acute central serous chorioretinopathy: Relationship with choriocapillaris and choroidal features.

The purpose of the present study was to measure in central serous chorioretinopathy (CSC) the salivary cortisol awake response (CAR) delta percentage (Δ%) variation, a distinct and robust indicator of cortisol rhythm during wakefulness, commonly proposed as a marker of hypothalamic-pituitary adrenal (HPA) axis activity, whose alteration is frequently associated with several adverse health outcomes. In the present cross-sectional observational study, salivary CAR Δ% variation was assessed in 17 adult male subjects affected by acute naïve CSC and compared to 17 matched healthy controls. Choroid vasculature metrics were assessed in the study population by measuring the subfoveal choroidal thickness (FCT) and the choroidal vascularity index (CVI) by the imaging technique of enhanced-depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT). Furthermore, flow signal void area features of the choriocapillaris were evaluated in the study population using OCT angiography (OCTA). Both the control and CSC groups showed a physiological cortisol increase that occurred during the first 30 min after awaking. However, CSC adult male patients showed remarkably blunted CAR Δ% variation in comparison with controls, which might reflect a CSC-related imbalance of HPA axis activity. Statistically significant correlations were shown by Pearson's correlation test between salivary CAR Δ% and the selected choroidal and choriocapillaris imaging biomarkers (FCT, CVI, and flow signal void area) in the study population. In conclusion, alterations of the CAR Δ% increase, associated with choroidal-retinal metrics, might provide a window into the physiopathology of acute CSC, suggesting a possible common factor to explain the association between stress and CSC.

Characteristics and Classification of Choroidal Caverns in Patients with Various Retinal and Chorioretinal Diseases

To investigate the features of choroidal caverns in diverse retinal diseases with swept-source optical coherence tomography (SS-OCT). Subjects with normal eyes, retinitis pigmentosa (RP), wet age-related macular degeneration (wAMD), acute central serous chorioretinopathy (CSC), or chronic CSC were enrolled. The characteristics of choroidal caverns were evaluated with SS-OCT. The prevalence of choroidal caverns in retinal diseases and the correlations between the number, width and depth of choroidal caverns with the thickness of choroid were analyzed. Among 315 eyes of 220 subjects, choroidal caverns were found in 110 eyes (34.9%). Choroidal caverns were divided into two categories based on their location and size. Type I was small and usually lobulated, presented in the choroidal capillary and Sattler's layers. Type II was larger, usually isolated, and presented in the Sattler's and Haller's layers. The prevalence of type I in subjects with normal eyes, RP, wAMD, acute CSC, or chronic CSC was 17.4%, 19.6%, 1.6%, 32.8%, and 85.2%, respectively, while that of type II was 0%, 0%, 21.3%, 13.8%, and 53.7%, respectively. The number, width, and thickness of type II choroidal caverns correlated positively with macular choroidal thickness. Choroidal caverns could be divided into two categories. Type II choroidal caverns appeared associated with the pachychoroid spectrum and RPE atrophic diseases.

Biomarkers predicting central serous chorioretinopathy episode persistence.

The purpose of this study was to identify biomarkers at presentation that are associated with a persistent central serous chorioretinopathy (CSC) episode. The prospective study included 35 patients with an acute CSC episode. Potential clinical and imaging biomarkers were evaluated at baseline and 3 months from the episode onset. As biomarkers age, sex, steroid use, episode recurrence, central retinal thickness (CRT), macular volume (MV), choroidal thickness (CT), pigment epithelial detachment (PED) height, and width, number of retinal hyperreflective foci (HF), leakage pattern, and area of retinal pigment epithelial (RPE) alterations were investigated. At 3 months from the CSC episode onset, spontaneous resolution occurred in 19 patients, while 16 patients had a persistent CSC episode. The group of patients with a persistent episode was statistically significantly associated with female sex (p = 0.032), older age (p = 0.015), wider PED (p = 0.005), and higher number of HF (p = 0.02). Moreover, this group of patients had a significant association with thinner choroid and diffuse RPE alterations as a pair (p = 0.008). Older and female CSC patients with wider PED, increased number of HF, thinner choroid, and diffuse RPE alterations at presentation are inclined to episode persistence and could benefit from earlier treatment.

The quantitative evaluation of retinal layers after resolution of subretinal fluid in acute central serous chorioretinopathy.

To evaluate the average retinal layer thicknesses in eyes with unilateral acute central serous chorioretinopathy (CSC) (with subretinal fluid (SRF)) and after complete resolution of SRF in these eyes and to compare the results with those obtained in healthy eyes. Fifty-four eyes of 27 patients with unilateral acute CSC (CSC in active phase) who had complete resolution of SRF and 25 eyes of 25 healthy control subjects enrolled in this retrospective study. The average thicknesses of the retinal layers were measured by segmentation analysis of optical coherence tomography at baseline and 6 months after complete resolution of SRF. The mean outer nuclear layer (ONL) thickness was significantly lower in eyes with CSC than in fellow eyes (p < 0.001). The mean ONL thickness was increased after resolution of SRF, but still low compared to unaffected fellow eye and the increment was not statistically significant (p > 0.05). There were significant strong inverse correlations between visual acuity and ONL thicknesses at baseline and 6 months after complete resolution of SRF (p < 0.001, r = - 0.810; p < 0.001, r = - 0.705, respectively). ONL thickness was thinned in cases with acute CSC, and although there was some increment in ONL thickness 6 months after complete resolution of SRF, it was still thinner compared to unaffected fellow eyes.

Evaluation of the effect of intravitreal antivascular endothelial growth factor versus medical treatment in acute central serous chorioretinopathy

Objective To assess the effectiveness of intravitreal ranibizumab or aflibercept versus medical therapy for treatment of patients presented with acute central serous chorioretinopathy. Patients and method This comparative controlled clinical trial involved 45 eyes of 45 patients having acute central serous chorioretinopathy. Patients were divided into three equal groups: the first patient group received intravitreal aflibercept, the second one received intravitreal ranibizumab, and the third one, control group, received medical therapy: oral spironolactone 100 mg once daily and topical bromfenac 0.09% q.i.d. All groups were observed over a duration of 6 months and assessed for best-corrected visual acuity (BCVA), pattern on fundus fluorescein angiography, duration of visual recovery, recurrence rate, and possible complications after intravitreal injections. The central macular thickness (CMT), the subfoveal choroidal thickness (CT), the subretinal fluid (SRF), and the foveal vascular density were compared across the groups. Results By the end of the follow-up, BCVA significantly (P&lt;0.01) improved in all groups. However, group comparison revealed no significant differences (P&gt;0.05). A significant reduction in the CMT due to resolution of the SRF existed at 2 weeks after treatment in all groups till complete resolution at 6 months. For subfoveal CT, within-group analysis reported nonsignificant (P&gt;0.05) differences in the intravitreal injection groups, whereas a significant (P&lt;0.05) reduction in CT was recorded in the control group at 3 and 6 months. The foveal vascular density showed nonsignificant differences (P&lt;0.05) within and among study groups. Conclusion Intravitreal injections had similar effects as medical treatment in improving BCVA, CMT, and SRF but had weaker action on CT.

Comparative study on retinal microvasculature changes between acute and chronic central serous chorioretinopathy.

Central serous chorioretinopathy (CSC) is generally a common fundus disease in young and middle-aged Asian men. Acute and chronic CSC can lead to different degrees of injury to the retinal blood flow. This study aims to observe and compare the blood flow density in different retinal capillary layers in patients with acute and chronic CSC using optical coherence tomography angiography (OCTA) technology. Twelve patients with acute CSC and 8 patients with chronic CSC including 12 eyes with acute CSC (acute CSC eye group), 11 eyes with chronic CSC (chronic CSC eye group), and 17 normal eyes (normal eye group) were enrolled in this study. All patients underwent 3 mm×3 mm, 6 mm×6 mm macular OCTA scanning. The retinal microvascu-lature was divided into superficial vascular complexes (SVC), intermediate capillary plexuses (ICP), and deep capillary plexuses (DCP) using the projection resolved-OCTA algorithm. Inner retina includes SVC, ICP, and DCP. The vessel density in each retinal layer and the inner retina were calculated and compared. Macular OCTA scanning of 3 mm×3 mm showed that there was no significant difference in blood flow density of SVC and ICP among the 3 groups (both P>0.05); blood flow density of DCP and inner retina in the chronic CSC eye group was significantly lower than that in the acute CSC eye group and the normal eye group (all P<0.05); there was no significant difference in retinal blood flow density of different layer between the acute CSC eye group and the normal eye group (all P>0.05). Macular OCTA scanning of 6 mm×6 mm showed that inner retinal blood flow density of the chronic CSC eye group was significantly lower than that of the acute CSC eye group and the normal eye group (both P<0.05); there was no significant difference in blood flow density of SVC among the 3 groups (P>0.05). The vessel density of DCP and inner retina in the eyes with chronic CSC are significantly reduced, which may result in impaired visual function. Therefore, we recommend that patients with acute CSC should be properly treated to avoid progressing into chronic CSC.

Development of the selective micropulse individual retinal therapy depends on age and type on the Fitzpatrick scale.

To develop a selective micropulse individual retinal therapy (SMIRT) based on the age and appearance type of the patient, to derive a formula for calculating power, and evaluate clinical efficacy for the treatment of central serous chorioretinopathy (CSCR). 73 patients (aged 30-65years) with acute CSCR and types 1-4 on the Fitzpatrick scale were divided into 2 groups. In the first group (33 patients), the testing of the micropulse mode (50µs, 2.4%, 10ms, 100µm, 0.4-1.9W) on the Navilas 577s laser system defined as selective by computer modeling was performed. A logistic regression function based on probability damage detection (PDD) of the 1584 laser spots from power, age, and type on the Fitzpatrick scale was constructed. PDD is the probability of detecting the laser spots using the autofluorescence method. The second group was divided into 4 subgroups of 10 eyes each. Groups 2.1, 2.2, and 2.3 were treated without preliminary testing. The power for Groups 2.1, 2.2, and 2.3 was obtained with the inverse PDD function, so that PDD was 50%, 70%, and 90%, respectively. Control group 2.4 went without treatment. The transmission and absorption coefficients of laser radiation of the eye depend on the age and the Fitzpatrick scale type. In Groups 2.1-2.3, complete resorption of subretinal fluid was observed 3months after CSCR treatment in 5 (P < 0.35), 8 (P < 0.023), and 10 eyes (P < 0.0008) out of 10, respectively. The developed SMIRT is effective for CSCR treatment with PDD 90%.

A Review of Central Serous Chorioretinopathy: Clinical Presentation and Management.

Central serous chorioretinopathy (CSC) may be understood as a disease of the chorioretina with the serous detachment of the neurosensory retina, which is secondary to single or multiple localized defects in retinal pigment epithelium (RPE). CSC is one of the common forms of loss of vision, usually seen in people who do belong to the working-age group. The most common symptoms are blurring of vision, usually unilateral and which is perceived as a scotoma in the center of the field of vision with associated metamorphopsia and micropsia. The risk factor associated with CSC is psychosocial stress, type A personality, pregnancy, and hypercortisolism. Normal vision is often restored within a span of a few months. After around three months, if the resolution of acute CSC did not change or, let us say, in the case of CSC that is chronic, one should consider treatment. In acute CSC, to resolve symptoms, especially in individuals who work in a field where eyesight is of utmost importance, for example, pilots, focal photocoagulation of leaking RPE lesions can be performed. CSC is a prototype cause of serous neuroretinal detachment, which involves the fovea. CSC symptoms reflect the separation between the RPE and the photoreceptors and the bullous distension of the foveal retina. The effect of therapy as such on the long-term outcome of vision visual is not sufficiently documented. The management would largely be dependent on the appropriate diagnosis made based on clinical presentations, and thus it becomes very much necessary to have knowledge about the same and counsel the patient regarding the association between stress and disease pathology. In acute CSC, retinal photocoagulation is successful to a good extent in eliminating or reducing the leakage of RPE and hence it induces resolution of the serous detachment. This review article is made to make sure the reader is updated about the various clinical and management aspects of CSC by providing a comprehensive idea that is obtained from various well-acknowledged databases across the globe on CSC.