Cases Of Central Serous Chorioretinopathy Research Articles

Quantitative assessment of intervortex anastomosis in central serous chorioretinopathy and fellow eyes: Does the size of anastomotic vessels matter for the diagnosis?

To evaluate the frequency and size of intervortex anastomosis at the posterior pole on en-face spectral domain optical coherence tomography (SD-OCT) images in central serous chorioretinopathy (CSC) cases and their fellow eyes and its associations with choroidal morphology. Sixty-five treatment-naive eyes of 65 patients with CSC, 65 fellow eyes, and 55 eyes of healthy age-matched participants were included. The presence of intervortex anastomosis at the watershed zone and asymmetry of the choroidal vessels between the superior and inferior macula were evaluated using 6 × 6mm en-face SD-OCT. The diameter of the widest Haller vessel and the diameter of the widest anastomotic Haller vessel passing through the watershed zone were measured on en-face SD-OCT images. The choroidal vascularity index (CVI) was assessed using ImageJ software. Intervortex vein anastomosis on the horizontal watershed zone was detected in 75.4% diseased eyes, 61.5% in fellow eyes, and 36.4% in healthy age-matched controls (p < 0.001). The mean CVI was significantly higher in both diseased (74.3 ± 2.3%) and fellow (73.8 ± 2.2%) eyes of CSC cases than in healthy controls (72.5 ± 2.3%) (p = 0.002, p = 0.013, respectively). In the cases with intervortex vein anastomosis, the diameter of the widest anastomotic Haller vessel passing through the watershed zone was 0.40 ± 0.10mm in diseased eyes, 0.35 ± 0.11mm in fellow eyes, and 0.30 ± 0.09mm in healthy age-matched controls (p = 0.001). Intervortex anastomosis might be seen as a variation in normal eyes, however, its frequency and the size of anastomotic vessels are significant higher in not only CSC but also in fellow eyes.

Leaking beehive honey sign an unusual case of central serous chorioretinopathy

Central serous chorioretinopathy is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy and branch retinal vein occlusion. It’s usually unilateral and affect young or middle-aged men with M: F - 3:1 whereas female tend to be older. It’s a common ocular disease characterized by decompensation of the retinal pigment epithelium, which results in neurosensory retinal detachment, serous pigment epithelium detachment, and retinal pigment epithelium atrophy. Early identification and treatment are needed to prevent complications. Conclusion: Patients may require early intervention to prevent loss of photoreceptor layer integrity. Though Majority of cases are self-resolving, mineralocorticoid antagonists can be given for faster resorption of subretinal fluid. Photo Dynamic Therapy may be required for cases of chronic Central Serous Chorioretinopathy.

Quantitative and comparative analysis of thermography parameters in posterior scleritis, choroiditis, and controls.

To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt-Koyanagi-Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls. This retrospective, observational, comparative study evaluated cases undergoing ocular thermography between April 2017 and October 2023. The study groups included cases of PS, CG, and VKH, while the control group comprised CSCR cases and healthy individuals. Various thermography parameters were assessed, which were as follows: Ocular surface temperature (OST), central corneal temperature (CCT), average scleral temperature (ST), nasal scleral temperature (nST), temperature difference between both the eyes (Dt), and difference between scleral and corneal temperatures (ST - CCT, nST - CCT). It was found that Dt was significantly higher in the PS group compared to the CG (P = 0.005), CSCR (P = 0.0001), and control groups (dilated control: P =0.006, undilated control: P = 0.0001). ST - CCT and nST - CCT were significantly higher in the undilated control and CSCR groups and significantly lower in the PS group. ST - CCT and nST - CCT showed less difference in the affected eyes compared to contralateral healthy eyes of PS and CG cases. OST, CCT, ST, and nST displayed statistically insignificant differences across all groups. It is advisable to focus on temperature differences between the affected and healthy eyes, or the difference between the central corneal and scleral temperature of the affected eye, utilizing parameters such as ∆t, ST - CCT, and nST - CCT. These composite parameters offer a more effective approach than individual measurements like OST, CCT, ST, and nST. Thermography can serve as a screening tool to suspect and differentiate PS.

Complete Resolution of Central Serous Chorioretinopathy Cases Treated with Low Power Mode Laser Technology : A Novel Approach

Introduction : Central serous chorioretinopathy (CSC) is an idiopathic condition mostly affecting men in their 20s to 50s. It is characterized by serous fluid accumulation behind the neurosensory retina resulting in a localized macular detachment. Aldosterone-receptor antagonist and photodynamic laser therapy are the current mainstay of treatments, although most CSC cases can resolves spontaneously within 2 to 3 months. Low power mode (LPM) laser has emerged as a new effective technology to treat CSC.&#x0D; Case Illustration : Case 1: A 50-year-old male was diagnosed with recurrent chronic CSC since 2 months ago. His visual acuity declined even after given oral aldosterone receptor antagonist for two weeks, so he was scheduled to undergo LPM. After three weeks of laser treatment, CSC resolved and the visual acuity improved (Figure1). Case 2 : A 47-year-old male complained of decreased vision and metamorphopsia on his right eye since two weeks ago. He was diagnosed with CSC and underwent LPM. Three weeks after LPM, his vision improved and the metamorphopsia resolved (Figure2). LPM helps the migration of retinal pigment epithelium (RPE) cells to restore the outer blood-retinal barrier through expression of heat shock proteins. We used MC-500ViXi laser system (Nidek Co., Gamagori, Japan) and the laser parameters used in this study were 100?m spot size, 0.01s exposure time, 0.25-0.5 spacing, and 30% LPM ratio.&#x0D; Discussion : &#x0D; Conclusion : LPM is a new yet promising treatment modalities to treat acute and chronic CSC. Its low power nature makes LPM a safe choice of treatment with less damage to the surrounding retina.

Acute Central Serous Chorioretinopathy Outbreak during the COVID-19 Pandemic: A Pilot Study.

Background and Objectives: This study aims to investigate the potential association between the COVID-19 pandemic and a new presentation of central serous chorioretinopathy (CSCR). Materials and Methods: A retrospective analysis was conducted, comparing the incidence of new-onset CSCR cases among ophthalmology patients in a regional medical facility in southern Israel between two distinct periods: the COVID-19 pandemic era in Israel, which occurred from 27 February 2020 to 20 December 2020, and the non-pandemic period from calendar years 2018 to 2021, excluding the specific epidemic phase mentioned. Disease severity was evaluated based on recovery time, visual acuity loss, and central macular thickness via OCT. Results: Over the four-year period, 35 new cases of CSCR were recorded. During the COVID-19 pandemic, 17 new cases (0.005% per population) were identified, compared with 18 new cases (0.002% per population) in the preceding three years. The odds ratio for acute CSCR during the pandemic was 2.83 (95% CI, 1.46-5.50) with a p-value of 0.02. CSCR cases during the pandemic seemed to exhibit worse clinical characteristics, though not statistically significant. Additionally, 22.2% of the COVID-19 pandemic group had confirmed COVID-19 cases, which was statistically significantly higher than the general population's reported cases (6%). Conclusion: The study revealed a statistically significant increase of over 2.5 times in acute CSCR incidence during the COVID-19 pandemic compared with non-pandemic periods. The findings suggest that the pandemic's stressful changes may have unintended consequences on the occurrence of CSCR, highlighting the importance of mental health support and psychoeducation for affected patients.

Central Serous Chorioretinopathy Risk Factors in An Iranian Cohort: A Case-control Study.

This study aimed to investigate the possible risk factors of central serous chorioretinopathy (CSCR) in an Iranian cohort. We recruited 39 consecutive CSCR cases and 80 age-matched controls with no ocular pathology from the same medical center from March 2019 to March 2021. Enrolled patients underwent complete ophthalmological examination and extensive history taking in a referral setting. Logistic regression analysis was performed to detect any possible association of potential risk factors with CSCR. The mean age of CSCR patients was 40.697.71 years. The male-to-female ratio in cases and controls was 1:1.79 and 1.22:1, respectively. Logistic regression analysis revealed that alcohol consumption (odds ratio, OR: 62.0, 0.001), smoking (OR: 4.0, 95% CI: 1.47-10.85, 0.006), corticosteroid use (OR: 6.95, 95% CI: 2.64-18.28, 0.001), and high psychological stress (OR: 13.34, 95% CI: 4.68-38.02, 0.01) were significant risk factors for developing CSCR. Ischemic heart disease (=0.550), hypertension (=0.750), and hyperopia (=0.467) were not associated with the risk of CSCR. The most common form of steroid use was oral in both groups. No pregnant female was present in the study sample, precluding the assessment of its potential association with CSCR. CSCR often affects individuals of productive working ages; thus, identifying its preventable risk factors is highly encouraged. Our results suggested that alcohol consumption, smoking, and high levels of psychological stress are independent, preventable risk factors for CSCR.

Случай центральной серозной хориоретинопатии после взрывной травмы

Relevance. Over the past decade, clinical cases of central serous chorioretinopathy after an eye injury have increasingly appeared in the press. Purpose. Currently, there are no cases of description of central serous chorioretinopathy after an explosive injury in the literature available for review. Presenting our clinical case, we will try to fill this gap. Methods. A 41-year-old man with concomitant injuries was admitted to inpatient treatment at a multidisciplinary clinic after a close detonation of a high-powered explosive device. At the end of the second week from the moment of injury, against the background of an improvement in the general well-being of the patient, the «flickering spot» in front of the gaze of the left eye began to actively disturb. On the 21st day after injury, both eyes were examined using an optical coherence tomograph with a rocking source (OCT) DRI OCT Triton by Topcon (Japan). In the lower quadrants on the edge of the macula of the left eye, a serous detachment of the neuroepithelium was detected with dimensions of 5310×5253 μm and a maximum height of 706 μm with two detachments of the retinal pigment epithelium. On the 28th day from the moment of injury, during the control OCT study, flattening was noted, but with an increase in the area of serous detachment of the neuroepithelium and the preservation of detachments of the retinal pigment epithelium. In connection with the professional requirements for the patient's state of health, delimiting laser coagulation of the retina was performed against the background of the treatment of concomitant pathology. Results and discussion. On the 33rd day after the injury, complete adherence of the serous detachment of the neuroepithelium and detachments of the retinal pigment epithelium was noted with the disappearance of the patient's complaints. Conclusion. The presented clinical case is of great interest, since eye trauma and, in particular, explosive trauma are quite rare causes of the development of central serous chorioretinopathy. Key words: clinical case, serous chorioretinopathy, neuroepithelial detachment, pigment epithelium detachment, blast injury, post-traumatic retinopathy, eye injury

Real-world practice patterns of eplerenone use for central serous chorioretinopathy

PurposeTo report eplerenone use by retina specialists worldwide for central serous chorioretinopathy (CSCR).MethodsA self-reporting questionnaire was distributed to retina specialists worldwide to gather clinicians’ perspectives on CSCR cases treated, eplerenone dosage and duration, reasons to use it, and side effects.ResultsThe survey included 241 retina specialists (122 Indian and 119 international) with an average experience of 15.69 ± 9.59 years. Oral eplerenone was used to treat CSCR by 149 (62%) participants. Only 6% (n = 9) had easy access to verteporfin dye and photodynamic therapy. 30 (20%) of the 149 respondents changed their treatment with eplerenone after VICI trial results. Eplerenone was prescribed mostly for chronic CSCR (n = 86, 58%), regardless of involvement laterality. 62% (n = 92) had fewer than 25% CSCR cases treated with eplerenone. 85 (57%) respondents used eplerenone only when other treatments failed, while 36 (24%) used it as first-line treatment. 73 (49%) respondents, prescribed eplerenone at a 50 mg daily dose and 137 (92%) retina specialists used eplerenone for 0–3 months. The drug’s efficacy dissatisfied 21 (14%) study participants. 124 (83%) study participants did not encounter any ocular or systemic side effects with eplerenone use. Eplerenone related kidney and electrolyte issues were noted by 11 (7%) study participants.ConclusionThe treatment of CSCR varies around the world and is primarily influenced by the photodynamic therapy availability and the findings of VICI trial. Despite the limited benefit of eplerenone reported by the VICI trial, it is still used as evidenced by real-world experience.Trial Registration NumberNot applicable.

Efficacy of Intravitreal Bevacizumab in management of Chronic Central Serous Chorioretinopathy: A Meta-Analysis of Prospective Studies

Background Central serous chorioretinopathy (CSC) is described as a chorio-retinal disease, associated with the serous detachment of the neurosensory retina and/or retinal pigment epithelium (RPE) most commonly seen in the macular region. Aim of the Work To evaluate the efficacy of Bevacizumab, an intravitreal vascular endothelial growth factor antagonist, in treatment of chronic central serous chorioretinopathy by conducting a Meta-Analysis of the available data from prospective studies. Materials and Methods A comprehensive literature search was conducted using the databases Google scholar, PubMed, MEDS, web of science, EMBASE and Cochrane Library for published studies till June 2021.This meta-analysis included eight studies. They were prospective studies, six of them were case series and the remaining two were randomised controlled trials (RCTs). 105 patients with chronic CSC (105 eyes) participated in these studies. Results This study demonstrated a statistically significant change in the mean of best corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction when comparing the baseline to one- three- and six-month follow-ups after the injection. No adverse effects were reported in any of the included studies. Conclusion Intra-vitreal injection of bevacizumab is an excellent alternative and conceivable treatment among currently available treatment options for chronic or recurrent or refractory cases of central serous chorioretinopathy.

Management of Central Serous Chorioretinopathy Using Focal Laser Photocoagulation: A Case Report

Introduction: Central serous chorioretinopathy (CSC) has the main symptoms of choroidal thickening, detachment of retinal pigment epithelium (RPE), and presence of subretinal fluid. Treatment of CSC is indicated for cases with SRF persisting for more than 4 months, decreased visual acuity, history of recurrence, or history of previous CSC in other eyes with poor visual outcome. This case report aims to describe the management of CSC using focal laser photocoagulation.&#x0D; Case presentation: A man, 41 years old, living in the city, came with complaints of sudden blurred vision in his left eye when he woke up 3 months ago. This complaint is accompanied by a decrease in the ability to see in the middle. There are no vision complaints such as flashes of light, no blurred vision such as tunnels or closed curtains, no red eyes, pain, or eye discharge. On ophthalmological examination, there was a decrease in visual acuity oculi sinistra (OS) 6/12, intraocular pressure within normal limits, and orthophoria. On examination of the posterior segment of the OS, a decreased positive foveal reflex was found. Fluorescent angiography fundus photo examination showed central serous chorioretinopathy OS. This patient was diagnosed with central serous chorioretinopathy oculi sinistra. Management is given to patients in the form of disease-related education, laser focal photocoagulation OS, clobazam 10 mg/24 hours, eye drops oxymetazoline HCl 1 drop in the left eye/8 hours.&#x0D; Conclusion: Treatment with laser focal photocoagulation is beneficial in the clinical improvement of cases of central serous chorioretinopathy.

Biometric Risk Factors for Central Serous Chorioretinopathy.

Central serous chorioretinopathy (CSCR) is a common disease that in chronic form can lead to significant visual impairment. Hence, the systemic and local risk factors of CSCR have been analyzed to possibly prevent its onset. The goal of the present study was to find the biometric parameters characteristic for CSCR. The study included 66 eyes of 60 consecutive patients who were diagnosed with acute or chronic CSCR between January 01 2021 and June 30 2021. There were 46 males and 14 females with a mean age of 48.8 ± 10.0years in the study cohort. Six patients had symptomatic binocular disease. The axial length and retinal parameters of all patients were measured with spectral domain optical coherence tomography (SD-OCT), and refraction error was tested after cycloplegia. The results of the affected eyes were compared with those of healthy fellow eyes (with exclusion of eyes previously affected by CSCR or with any other ocular disorder) (39 eyes) and the control group (75 eyes), and correlated to the duration of the disease. No significant differences were revealed in axial length between the affected eyes, healthy fellow eyes, and controls (23.31 ± 1.06mm versus 23.59 ± 1.20mm versus 23.33 ± 1.19mm, respectively). The distribution of refraction errors was similar in the three analyzed groups. A hypermetropic shift was noted in the affected eyes versus controls (p = 0.030); however, no difference was noted in refraction error between the healthy fellow CSCR eyes and controls (p = 0.418). Both acute and chronic CSCR cases, as well as their fellow eyes, demonstrated significantly greater choroidal thickness compared with healthy individuals (p < 0.001). Longer disease duration was correlated with a significant deficit in macular volume and average central retinal thickness (p < 0.05). CSCR is a clinical entity that can occur in patients with every type of refraction error. A shorter axial length of the eyeball is not associated with the diagnosis of CSCR; however, increased choroidal thickness is typical of this entity. Longer disease duration is correlated with the loss of retinal thickness and volume.

Risk of Central Serous Chorioretinopathy in Male Androgen Abusers.

Male gender is an important risk factor of central serous chorioretinopathy (CSC), and studies have explored the pathophysiological role of androgens in CSC with conflicting results. In this study, we shed light on this hot topic by exploring the risk of CSC in a large cohort of male androgen abusers. This study included male androgen abusers identified through a nationwide anti-doping test program across Danish fitness centers from January 3 2006 to March 1 2018. For each case, we randomly sampled ten male controls using Danish nationwide registries. These controls were matched in age and date. Cases and controls were followed until May 16 2018. Data on diagnoses were extracted using the Danish National Registry of Patients using ICD-10 codes to identify cases with CSC. We included 1189 cases and 11,890 controls. Mean age at the time of doping sentence was 27.4 ± 6.9years, and mean length of follow-up was 15.8 ± 3.6years. We identified no cases of CSC in androgen abusers, and five cases of CSC in the control cohort. The difference between groups was not statistically significant (P = 1.0). Male androgen abusers were not at increased risk of CSC. Considering the lack of any signal in this large study, we speculate that if male androgen plays any direct role in the pathophysiology of CSC, its role may be subtle at best.

Central Serous Chorioretinopathy in a 14-year-old atopic boy: a case report

BackgroundCorticosteroids are widely used in medicine. Few cases of central serous chorioretinopathy (CSC) have been reported following topical corticosteroid administration. We describe the first case of pediatric CSC related to topical corticosteroid administration.Case presentationA 14-year-old boy presented with decreased vision, pigment epithelial detachments, and serous retinal detachments in the right eye after starting treatment for atopic dermatitis with Betamethasone Valerate 0.1% topical ointment. His condition resolved 2 weeks after discontinuing the steroid and administering Bromfenac 0.9 mg/ml eyedrops.ConclusionsAlthough the pathogenesis of CSC is poorly understood, ophthalmologists should be informed about the potential link between CSC and topical corticosteroid treatment, and they should be aware that CSC might, albeit infrequently, affect children.

Efficacy and Safety of Laser Photocoagulation in Persistent Idiopathic Central Serous Chorioretinopathy: A Prospective Interventional Study

Introduction: Central Serous Chorioretinopathy (CSCR) encompasses the macular area, secondary to the accumulation of subretinal fluid and increased permeability from the choriocapillaris resulting in focal or diffuse dysfunction of the retinal pigment epithelium. Diagnosis of CSCR is done by several procedures like clinical examination, Amsler grid testing, fluorescein angiography, ocular coherence tomography. There are several treatment options including photodynamic therapy, laser photocoagulation, etc., for CSCR. Aim: To study the efficacy and safety of laser photocoagulation in persistent idiopathic CSCR. Materials and Methods: The present prospective interventional study was conducted in the Department of Ophthalmology, BJ Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India, from August 2019 to January 2021. A total of 30 patients (30 eyes) with idiopathic CSCR, persistent for duration of three months or more with worsening of visual symptoms, active leakage on Fundus Fluoresceine Angiography (FFA) were subjected to 532 nm subthreshold green laser photocoagulation treatment after routine investigations. Statistical analysis was done on International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 20.0. Results: In the present study, there was male preponderance (86.7%) for the CSCR cases. The mean±Standard Deviation (SD) age of in the study was 37.7±0.07 years. All the eyes studied had unilateral involvement with 53.35% right eye involvement and 46.7% left eye involvement. The duration of current episode of CSCR in months showed a mean+SD of 5.86±1.40. The distribution of visual acuity in affected eye (before laser treatment) depicts the mean prelaser Best Corrected Visual Acuity (BCVA) of 30 patients at baseline was (0.68±0.20) in LogMAR. About 67% patients experienced central scotoma and 33% patients had metamorphopsia on Amsler chart. Distribution of active leakage site on FFA showed that 43% cases had active leakage in superonasal quadrant, 30% had active leakage in superotemporal, 17% had active leak in inferonasal quadrant and 10% had active leak in inferotemporal quadrant. CSCR associated with or without Retinal Pigment Epithelium (RPE) atrophy showed that 63.3% patients had RPE atrophy suggesting long-standing course of disease with NSD and subretinal fluid collection affecting RPE. Prelaser mean CMT on OCT of affected eye was 445.83±54.79 µm which was reduced to mean CMT of 303.57±48.49 µm at four weeks follow up, which further reduced to mean CMT of 224.9±20 µm at end of 12 weeks was statistically significant with p-value&lt;0.001. The statistical analysis for the macular thickness at four weeks and 12 weeks showed significant probability with paired t-test with p-value&lt;0.001. Conclusion: It can be concluded from the present study that early treatment with laser photocoagulation is efficient in the restoration of vision within a period of 12 weeks.

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.

Central serous chorioretinopathy and angioid streaks: coincidental?

BackgroundTo report an unusual case of central serous chorioretinopathy in a patient with angioid streaks.Case presentationThe authors describe a case report of a 26-year old male patient presenting acute scotoma and metamorphopsia in OD. He had been diagnosed with angioid streaks complicated with choroidal neovascularization and referred to us for treatment. The patient presented an ETDRS score of 85 letters (20/20) in OD and in OS. The anterior segment examination was unremarkable. Fundoscopy revealed bilateral angioid streaks (AS) and peau d’orange, as well as a small neurosensory retinal detachment in the macula of OD. A multimodal retinal analysis, including fundus photography, infra-red and fundus autofluorescence imaging, spectral-domain optical coherence tomography, optical coherence tomography angiography, fluorescein and indocyanine green angiography was performed. The diagnosis of central serous chorioretinopathy was made in the absence of any identifiable choroidal neovascularization. He was submitted to half-dose photodynamic therapy with verteporfin. One month later, he reported no visual complaints, his vision was 85 letters (20/20) in OD and a complete resolution of the sub-retinal fluid was registered. No signs of choroidal neovascularization were detected on the optical coherence tomography angiography (OCTA). A complete medical workup evaluation was made to exclude systemic diseases usually associated with AS.ConclusionsTo the authors’ knowledge, this is the second reported case of CSC associated with angioid streaks. The focal abnormalities in the Bruch’s membrane and the irregular vascular choriocapillary network associated with AS might predispose to CSC.

Clinical Profile and Risk Factors of Central Serous Chorioretinopathy in Al- Ain, United Arab Emirates

Background: Based on the adverse event reporting system, the authors observed unique occupational and pharmacological trends in central serous chorioretinopathy (CSC); despite being a common condition in the region, there are no large epidemiological studies. Objective: To describe the clinical profile, risk factors and co-medications of CSC in a multispecialty hospital in UAE. Methods: Hospital based retrospective, observational study in which all the confirmed cases of CSC (272) seen between 2010 and 2019 were included. Supplementary data was collected on follow up visits or through telephonic calls. Results: The male: female ratio was 17:1; low socio-economic status was (155; 73.45%), and occupations such as drivers (61; 28.9%) and outdoor laborers (59; 27.96%) were the most commonly affected. The majority (78.05%; 185) were single expatriates. Financial worries (105; 50.72%) constituted the leading cause of stress. The usage of corticosteroids (83; 30.51%), nasal decongestants (14.70%) or both (17; 6.25%) within one year was common; mostly (82; 30.14%) for rhinitis/respiratory states, though grossly under-recognized. Muscle relaxants and psychotropic medications were the other major medications used by 24 (8.82%) and 25 (9.19%) cases prior to CSC. Seven of 15 women had at least one condition that alters the endocrinal milieu: Pregnancy (3), recent child birth (1), erratic oral contraceptive intake (1), menopause with liver dysfunction (1), hormone replacement therapy for menopause and endometriosis (1), ovarian cyst and infertility (1) hypothyroidism (3), and Cushing syndrome (1). Chronic/ recurrent forms were seen in 31.08%. There were too few glaucoma patients despite both CSC and glaucoma being common among our patients. Conclusions: CSC in Al-Ain predominantly affected males with a specific occupational predisposition. Emotional distress, financial worries, allergic disorders, and endocrinal disorders (among females) were common. Adverse drug events were under-reported compared to the usage of steroid or decongestant users. Suspected pharmacological associations included drugs that modulated the vasomotor tone.

The Association Between Circulating Sex Hormones and Central Serous Chorioretinopathy: A Case-Control Study.

BackgroundCentral serous chorioretinopathy (CSC) is preferential cocurated in males, however the associations between sex hormones and CSC incidence or progression remains unclear. The sex hormone concentration assessments in CSC cases and healthy controls will update the knowledge in CSC management.MethodsThis case-control study included 59 CSC cases and 30 healthy controls, from January 2019 to December 2020. The CSC cases would be defined as spontaneous resolved if the subretinal fluid were absorbed within three months. The concentrations of total testosterone (TT), free testosterone (FT), estradiol (E2), sex hormone-binding globulin (SHBG), progesterone, leuteinizing hormone (LH) and dehydroepiandrosterone sulfate (DHEA-S) were detected in all the participants. The relationships between sex hormone concentrations and CSC-related characteristics were analyzed with Pearson correlation analyses.ResultsSignificantly increased TT, FT, FT/E2 ratio, SHBG concentrations as well as decreased DHEA-S level were detected in non-resolved CSC group compared with the control group. Comparing with the resolved ones, it was found that TT, FT and SHBG concentrations were increased in the non-resolved CSC. A significant positive correlation between TT concentrations and CMT (R2=0.168, P=0.031) as well as SRF height (R2=0.146, P=0.045) were detected in the non-solved CSC group.ConclusionDifferent concentrations of TT, FT, FT/E2 ratio, DHEA-S and SHBG were detected in resolved and non-resolved CSC cases. Sex hormones were related to CSC symptom durations and related parameters.

Brachytherapy for Central Serous Chorioretinopathy.

Brachytherapy is widely used for the treatment of choroidal melanoma and has recently been explored for the treatment of wet age-related macular degeneration. We propose the use of low dose radiation via episcleral brachytherapy in refractory cases of central serous chorioretinopathy (CSCR). The pathogenesis of CSCR involves dilatation and hyperpermeability of large choroidal vessels. Low dose radiation can induce intimal proliferation in large choroidal vessels and decrease their hyperpermeability. Concerns about the use of brachytherapy in CSCR include damage to the choriocapillaris or the retinal vessels. This can be addressed with the use of a specialized device through which a very precise and appropriate dose can be delivered. The dose of the radiation delivered decreases exponentially at a depth of approximately 0.5–1.5 mm from the devise–sclera interface. Considering an increased choroidal thickness in cases of CSCR, delivery of a safe dose can be assured.

Acute Unilateral Central Serous Chorioretinopathy after Immunization with Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Literature Review

ABSTRACTIntroductionA 43-year-old Caucasian male presented to our ophthalmology clinic with blurry vision and metamorphopsia in his right eye, 24 hours after receiving the first dose of the Pfizer–BioNTech COVID-19 vaccine.MethodsClinical examination and imaging tests were consistent with acute unilateral central serous chorioretinopathy (CSCR) that completely resolved after 2 months without any treatment. He had no significant ophthalmic or medical history. He also lacked the classical risk factors for CSCR such as recent psychosocial stressors, Type-A personality traits, history of exogenous steroid use, connective tissue disorders and obstructive sleep apnea.ResultsThis appears to be only the second reported case of CSCR, temporally associated with a recombinant COVID-19 mRNA vaccine. We also present a summary of published reports demonstrating intraocular complications associated with the novel recombinant COVID-19 mRNA vaccines.ConclusionFindings in this report should not deter COVID-19 vaccinations given the rarity of aforementioned ocular complications and the greater benefit of protection from COVID-19 infection. Medical practitioners, however, should remain mindful of potential ocular complications, given the greater likelihood of occurrence with increasing vaccination booster rates.