Chronic Central Serous Chorioretinopathy-Like Maculopathy as Atypical Presentation of Chorioretinal Folds

Purpose: The purpose of this case report was to present the clinical data and management of a 69-year-old female patient with chorioretinal folds who developed chronic central serous chorioretinopathy-like maculopathy. Case Presentation: A 69-year-old female patient presented with a recent-onset slight decrease in visual acuity in her left eye. Her past ocular history was clear. Regarding her medical history, she had only hypertension, treated with per os medications. The patient underwent a complete ophthalmological examination. At presentation, the visual acuity was 6/6 in the right eye and 6/7.5 in the left eye. Intraocular pressure was 16 mm Ηg in both eyes. On fundoscopy, chorioretinal folds were noticed in the left eye. Spectral-domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography confirmed the diagnosis of chronic central serous chorioretinopathy-like maculopathy in the left eye, since other causes of chorioretinal folding were excluded. The right eye was normal. No treatment was given to the patient, and at the 6-month follow-up there was improvement in visual acuity, which was 6/6, and decreased subretinal fluid. Conclusions: Central serous chorioretinopathy-like maculopathy should be taken into account for the differential diagnosis of patients with chorioretinal folds.

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Eplerenone for the treatment of chronic central serous chorioretinopathy: 3-year clinical experience

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314047 ◽

2019 ◽

Vol 104 (2) ◽

pp. 182-187 ◽

Cited By ~ 6

Author(s):

Daniel S Petkovsek ◽

Daniel G Cherfan ◽

Felipe F Conti ◽

Grant L Hom ◽

Justin P Ehlers ◽

...

Keyword(s):

Visual Acuity ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

First Year ◽

Chronic Central Serous Chorioretinopathy ◽

Mineralocorticoid Receptor Antagonist ◽

Institutional Review ◽

Central Subfield Thickness ◽

Small Cohort

Background/aimsThe efficacy of mineralocorticoid receptor antagonist eplerenone to treat chronic central serous chorioretinopathy (CSCR) has been established. However, previous studies have been limited by small cohort size and short follow-up duration. This study aims to report 3-year clinical outcomes of patients treated with eplerenone for chronic CSCR.MethodsInstitutional review board-approved retrospective chart analysis at a single institution from 2012 to 2018. Baseline best-corrected visual acuity and anatomical measurements related to degree of subretinal fluid (SRF) were collected at eplerenone initiation. Follow-up data were collected at the closest date to 12, 24 and 36 months.ResultsData were obtained for 100 eyes of 83 patients at 1-year (mean 11.18 ± 4.00 months), 49 eyes at 2-year (24.01 ± 3.33 months) and 33 eyes at 3-year (mean 35.5 ± 7.89 months) follow-up visits. The rate of complete SRF resolution was 31%, 28% and 33%, respectively. At final follow-up, logarithm of the minimum angle of resolution visual acuity change from baseline was +0.10 ± 0.24 (p = 0.130). Average change from baseline at final follow-up for central subfield thickness was −97 ± 140.6 µm (p < 0.001), cube volume was –1.07 ± 1.71 mm3 (p < 0.001), macular thickness –28. 5 ± 47.5 µm (p < 0.001), maximum SRF height was −95.6 ± 160.5 µm (p < 0.001) and maximum SRF diameter was −1169.0 ± 1638.7 µm (p = 0.008).ConclusionAnatomical improvement occurs primarily within the first year of eplerenone treatment for chronic CSCR.

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Subthreshold Micropulse Laser (577 nm) Treatment in Chronic Central Serous Chorioretinopathy

Ophthalmologica ◽

10.1159/000439600 ◽

2015 ◽

Vol 234 (4) ◽

pp. 189-194 ◽

Cited By ~ 31

Author(s):

Paula Scholz ◽

Lebriz Ersoy ◽

Camiel J.F. Boon ◽

Sascha Fauser

Keyword(s):

Visual Acuity ◽

Retrospective Study ◽

Central Serous Chorioretinopathy ◽

Retinal Thickness ◽

Imaging Modality ◽

Subretinal Fluid ◽

Chronic Central Serous Chorioretinopathy ◽

Micropulse Laser ◽

Subthreshold Micropulse Laser

Purpose: To assess treatment with a 577-nm subthreshold micropulse laser (SML) in patients with chronic central serous chorioretinopathy (cCSC). Methods: This retrospective study included 38 patients treated with a 577-nm SML (Supra Scan; Quantel Medical) for cCSC. We included a subgroup of 18 patients with persistent subretinal fluid (SRF) after photodynamic therapy (PDT). Assessment included visual acuity (VA), central retinal thickness (CRT) and resolution of SRF. Results: At the last follow-up (mean 5 months), 74% of patients responded to therapy. The CRT decreased after treatment (mean CRT -115 µm, p < 0.001) and VA improved (mean logMAR -0.06, p = 0.039). No laser burns were detected with any imaging modality. In the subgroup of patients resistant to PDT, 61% of patients responded to therapy with a decrease in CRT (mean CRT -75 µm, p = 0.019). Conclusions: The 577-nm SML is an effective treatment for cCSC even in patients without sufficient improvement after PDT.

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Non-central serous chorioretinopathy in a patient with systemic lupus erythematosus and hydroxychloroquine retinopathy

BMJ Case Reports ◽

10.1136/bcr-2020-237243 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237243

Author(s):

Diogo Hipolito-Fernandes ◽

Maria Elisa Luís ◽

Rita Flores ◽

Rita Anjos

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Central Serous Chorioretinopathy ◽

Vision Loss ◽

Subretinal Fluid ◽

Ophthalmological Examination ◽

Systemic Lupus ◽

Diagnostic Challenge ◽

Hydroxychloroquine Retinopathy ◽

The Right

Subretinal fluid accumulation in a patient with systemic lupus erythematosus (SLE) may represent a diagnostic challenge. We present a case of a 43-year-old man with baseline diagnosis of SLE and hydroxychloroquine-associated maculopathy who reported progressive vision loss on the right eye, associated with corticosteroids use for an arthritic crisis. Ophthalmological examination did not reveal any acute finding. On optical coherence tomography, subretinal fluid in the perifoveal area was visible on the right eye, with corresponding enlargement of the visual field defect. An increased choroidal thickness was also visible. Fluorescein angiography revealed, on the right eye, two pinpoint areas of leakage and indocyanine green angiography signs of choroidal vascular hyperpermeability. Considering a diagnosis of a non-central central serous chorioretinopathy, corticosteroids use was interrupted, with resolution of the subretinal fluid. This case illustrates the relevance of a multimodal imaging approach to guide the diagnosis of patient with an SLE with subretinal fluid.

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Short-term eplerenone for treatment of chronic central serous chorioretinopathy; a prospective study

International Journal of Retina and Vitreous ◽

10.1186/s40942-019-0190-y ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Hamid-Reza Moein ◽

Lauren W. Bierman ◽

Eduardo A. Novais ◽

Carlos Moreira-Neto ◽

Caroline R. Baumal ◽

...

Keyword(s):

Visual Acuity ◽

Prospective Study ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Enhanced Depth Imaging ◽

Short Term ◽

Chronic Central Serous Chorioretinopathy ◽

Therapeutic Trials ◽

Imaging Optical Coherence Tomography ◽

A Prospective Study

Abstract Background Increased mineralocorticoid activity is one of the plausible causes of chronic central serous chorioretinopathy (CSCR) and mineralocorticoid inhibitors such as eplerenone have been investigated as its potential therapy. This study investigates the short-term safety and efficacy of oral eplerenone in patients with chronic CSCR. Patients and methods Prospective study of 13 eyes of 13 patients with the diagnosis of chronic CSCR. All patients received eplerenone 50 mg/day for 4 weeks. Enhanced depth imaging optical coherence tomography (OCT) was obtained. Best corrected visual acuity (BCVA), and OCT parameters including sub retinal fluid (SRF), choroidal thickness (CT) and central macular thickness (CMT), were measured manually. Results The mean SRF height decreased slightly at 1-month follow-up as compared to baseline, but the change was not statistically significant (94.18 ± 17.53 vs. 113.15 ± 18.69; p = 0.08). Subfoveal CT and CMT was significantly reduced as compared to baseline (6.6% [p = 0.002] and 7.05% [p = 0.04], respectively). The BCVA did not change significantly (20/28 vs. 20/30 [p = 0.16]). Conclusion This study suggests that oral eplerenone may be used as a safe and potentially effective treatment in chronic CSCR, however there are minimal short-term effects on subretinal fluid or visual acuity therefore therapeutic trials longer than one month are necessary to test its benefits. Trial registration Clinicaltrials.gov identification number: NCT01822561. Registered 3/25/13, https://clinicaltrials.gov/ct2/show/study/NCT01822561

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Comprehensive evaluation of intravitreal conbercept versus half-dose photodynamic therapy for chronic central serous chorioretinopathy

International Journal of Ophthalmology ◽

10.18240/ijo.2021.05.12 ◽

2021 ◽

Vol 14 (5) ◽

pp. 719-724

Author(s):

Jian-Bo Mao ◽

◽

Chen-Yi Liu ◽

Yun Zhang ◽

Jing-Jing Lin ◽

...

Keyword(s):

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Comprehensive Evaluation ◽

Subretinal Fluid ◽

Chronic Central Serous Chorioretinopathy ◽

Treatment Groups ◽

Full Resolution ◽

Long Term Effect ◽

Half Dose

AIM: To compare the safety and efficacy of conbercept intravitreal injection and half-dose photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: This study was retrospective. Thirty-seven patients (37 eyes) with chronic CSC received conbercept injections while 57 patients (57 eyes) were treated with half-dose PDT. All subjects were followed in 6mo. Outcome measures included change in best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and resolution of subretinal fluid (SRF). RESULTS: There was no adverse event observed in either treatment group. At the 6-month follow-up, 26 eyes (70.3%) in the conbercept group and 54 eyes (94.7%) in the half-dose PDT group (P<0.05) reached full resolution of SRF. The mean logarithm of the minimum angle of resolution (logMAR) BCVA significantly improved (P<0.001) in both treatment groups with better outcome at early phase in the half-dose PDT group (2wk, 1, and 2mo, P<0.05). All subjects experienced significant CMT improvement (P<0.001) with no statistical difference between the two groups (P>0.05). The SFCT also improved in all subjects (P<0.001) with better outcome in the half-dose PDT group (P<0.05). CONCLUSION: Both intravitreal conbercept and half-dose PDT are safe to use in treating chronic CSC. By 6mo, both treatment groups are efficacious in improving BCVA, reducing CMT and SFCT, and resolving SRF in eyes with chronic CSC. Half-dose PDT may show better outcome at initial phase of treatment in chronic CSC. Longer follow-up period is necessary to study for long-term effect and safety.

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Fingolimod-associated central serous chorioretinopathy in a young girl

BMJ Case Reports ◽

10.1136/bcr-2021-243207 ◽

2021 ◽

Vol 14 (8) ◽

pp. e243207

Author(s):

Gajanan Chavhan Pratima ◽

Doris Benita ◽

Sandip Sarkar ◽

Amit Kumar Deb

Keyword(s):

Central Serous Chorioretinopathy ◽

Complete Resolution ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Corrected Visual Acuity ◽

Sphingosine 1 Phosphate ◽

Eye Examination ◽

The Right

Fingolimod is a sphingosine-1-phosphate analogue used for the treatment of multiple sclerosis. We, hereby, report a rare case of fingolimod-associated central serous chorioretinopathy (CSCR) in a 21-year-old woman who presented with blurring of vision in the right eye 3 weeks after initiation of oral fingolimod. On examination, best-corrected visual acuity was 20/20 in both the eyes. Fundus examination revealed shallow, serous macular neurosensory detachment in the right eye, and it was confirmed with spectral domain optical coherence tomography. Left eye fundus was normal. Fluorescein angiography showed focal retinal pigment epithelium leak inferior to the fovea. A diagnosis of fingolimod-associated CSCR was made. Oral fingolimod was discontinued. Subsequent follow-up visits showed partial resolution of CSCR at 2 weeks and at 1 month and complete resolution of the subretinal fluid at 2 months. CSCR is, therefore, a rare adverse effect of oral fingolimod treatment. Baseline eye examination and subsequent follow-up at regular intervals are recommended for patients on fingolimod.

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Morphologic Changes in the Foveal Photoreceptor Layer before and after Laser Treatment in Acute and Chronic Central Serous Chorioretinopathy Documented in Spectral-Domain Optical Coherence Tomography

Journal of Ophthalmology ◽

10.1155/2013/361513 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Dominik Odrobina ◽

Iwona Laudańska-Olszewska ◽

Piotr Gozdek ◽

Mariusz Maroszyński ◽

Michael Amon

Keyword(s):

Laser Treatment ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Chronic Central Serous Chorioretinopathy ◽

Microstructural Changes ◽

Photoreceptor Layer ◽

Before And After ◽

Group A ◽

Group B

Purpose. To analyze microstructural changes in the external limiting membrane (ELM) and photoreceptor layer before and after early and late conventional laser treatment in central serous chorioretinopathy (CSC) in 12 months follow-up study.Methods. A retrospective observational study included Group A: 19 patients (19 eyes) with symptomatic acute CSC and Group B: 16 patients (16 eyes) with symptomatic chronic CSC. Retinal microstructural changes were analyzed with SD-OCT paying a particular role in examining the photoreceptor layer and ELM.Results. The length of the photoreceptors, prior to treatment, was approximately 84 μm in Group A and 82,5 μm in Group B. Twelve months after laser treatment, photoreceptor length was approximately 49 μm in Group A and 43 μm (range 20–55 μm) in Group B. No patients in Group A had noticeable photoreceptor defects nor ELM defects, but in 15 eyes in Group B photoreceptor and ELM defects were detected ().Conclusions. When analyzing the photoreceptor layer and ELM during active CSC, it is not possible to evaluate any irreversible changes which have already occurred in this layer. Damage to the photoreceptor layer and ELM in patients with chronic CSC was only found after laser treatment and the absorption of subretinal fluid.

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Development of Central Serous Chorioretinopathy following Chalazion Removal with Intralesional Triamcinolone Injection: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000492714 ◽

2018 ◽

Vol 9 (3) ◽

pp. 416-420 ◽

Cited By ~ 3

Author(s):

Luca Rosignoli ◽

Stephen Myles Potter ◽

Andres Gonzalez ◽

Sarina Amin ◽

Syed G. Khurshid

Keyword(s):

Visual Acuity ◽

Central Serous Chorioretinopathy ◽

Low Dose ◽

Subretinal Fluid ◽

Intralesional Injection ◽

Short Term ◽

Corticosteroid Administration ◽

Triamcinolone Injection

We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease.

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Comparison of 532 nm Micropulse Green Laser versus Continuous-Wave 532 nm Green Laser in Chronic Central Serous Chorioretinopathy: Long-Term Follow-Up

Journal of Ophthalmology ◽

10.1155/2020/4604567 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Katarzyna Piasecka ◽

Piotr Gozdek ◽

Mariusz Maroszyński ◽

Dominik Odrobina

Keyword(s):

Central Serous Chorioretinopathy ◽

Continuous Wave ◽

Subretinal Fluid ◽

Green Laser ◽

Chronic Central Serous Chorioretinopathy ◽

Micropulse Laser ◽

Group A ◽

Group B ◽

532 Nm

The aim of this study was to analyze the efficacy of micropulse laser treatment (MLT) compared with the continuous-wave laser (CL) in treating eyes with chronic central serous chorioretinopathy (CSC) in a 12-month follow-up study. Methods: A retrospective observational study included 51 eyes with chronic CSC; 35 eyes were treated with MLT (Group A), and 16 eyes were treated with CL (Group B). We analyzed the best corrected visual acuity (BCVA) and retinal microstructural changes in spectral optical coherence tomography before the treatment, one and twelve months after the laser procedure. Results: The final mean BCVA was 0.89 ± 0.13 in Group A and 0.71 ± 0.17 in Group B. Photoreceptor length decreased significantly in both groups and amounted 61.2 μm in Group A and 42.9 μm in Group B one year after the treatment. Complete absorption of subretinal fluid twelve months after the laser procedure was noted in 74.3% eyes in Group A and in 87.5% eyes in group B. Hyper-reflective subretinal deposits were observed in 10/35 eyes in Group A but in 15/16 eyes in Group B on the final follow-up visit. Conclusion. MLT-treated patients showed better functional and microstructural results than patients treated with CL.

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Functional and morphological retinal impairment following resolved chronic central serous chorioretinopathy

10.21203/rs.2.29/v1 ◽

2018 ◽

Author(s):

Maciej Gawęcki ◽

Agnieszka Jaszczuk-Maciejewska ◽

Anna Jurska-Jaśko ◽

Małgorzata Kneba ◽

Andrzej Grzybowski

Keyword(s):

Visual Acuity ◽

Central Serous Chorioretinopathy ◽

Retinal Thickness ◽

Subretinal Fluid ◽

Central Retinal Thickness ◽

Morphological Parameters ◽

Chronic Central Serous Chorioretinopathy ◽

Micropulse Laser ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

Abstract Purpose Central serous chorioretinopathy is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods Thirty-two eyes with chronic central serous chorioretinopathy in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choroidal perfusion even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. No significant correlation between duration of central serous chorioretinopathy and amount of visual deficit has been found, therefore it is possible that the biggest damage occurs within the first months of active chorioretinopathy. Keywords: chronic central serous chorioretinopathy, micropulse laser, central retinal thickness, subretinal fluid

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