Advances in the treatment of central serous chorioretinopathy
“Central serous chorioretinopathy is a disease that is partly understood. Novel advancements have led to further understanding of the disease, and have identified choroidal dysfunction as the principal element in CSCR development”.
Left eye of a 48-year-old man with recurrent CSCR who was misdiagnosed as wet macular degeneration. Note the dull foveal reflex and RPE atrophic changes (top right). Fluorescein angiography shows diffuse irregular hyperfluorescence (top left). Optical coherence tomography shows shallow subretinal fluid reaching the fovea (Down).
Image courtesy of https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625218/
“New imaging tools have aided in better monitoring disease response to various treatment models. Enhanced depth imaging optical coherence tomography, in particular, has helped in observing choroidal thickness changes after various treatment models. To date, photodynamic therapy and focal laser remain the main stay of treatment. More understanding of disease pathophysiology in the future will help in determining the drug of choice and the best management option for such cases”.
“Bae et al. demonstrated in another RCT that reduced-fluence PDT was superior to 3 monthly doses of intravitreal ranibizumab”.
“They found that over 1-year of follow-up, 16 eyes (89%) remained dry in the PDT group versus only 2 eyes (12.5%) in the ranibizumab group. Visual acuity improved in both groups, but the difference was significantly better in the PDT group at the 3-month time point.”