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

2018 ◽  
Vol 9 (3) ◽  
pp. 416-420 ◽  
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.

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

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

Role of intravitreal ranibizumab for rapid recovery of central serous chorioretinopathy

2020 ◽  
Vol 14 (2) ◽  
pp. 78-82
Author(s):  
Kamran Shahzad ◽  
Syed Ahmer Hussain ◽  
Muhammad Zafarullah ◽  
Nausherwan Adil
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Rapid Recovery ◽  
Post Injection ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Best Corrected Visual Acuity

Background: Central serous chorioretinopathy (CSCR) is an idiopathic disorder in which there is leakage of fluid from hyper permeable choriocapillaris and the collection of fluid between neurosensory and neuropigmentry retina in the macular area that is responsible for decrease visual acuity. CSCR may be acute or chronic. Various treatment options include simple observation, argon laser photocoagulation of the leaking spot, photodynamic therapy (PDT), oral ketoconazole and oral rifampicin are available. Ranibizumab is a monoclonal antibody fragment that act as vascular endothelial growth factor inhibitor, stabilize blood retinal barrier and decrease leakage from choriocapillaris. This study aims to evaluate the role of intravitreal ranibizumab for rapid recovery in central serous chorioretinopathy. Patients and methods: This descriptive case series was carried out at Department of Ophthalmology, Nishtar Medical University Multan, Pakistan from 01-10-2019 till 30-04-2020. The study included twelve eyes of twelve patients suffering from acute CSCR. All patients were given a single injection of intravitreal ranibizumab (0.5mg/0.05ml) as a primary treatment and followed for two months after injection at one week, one month and two months interval to document efficacy of intravitreal ranibizumab. At each baseline and follow up visits, dilated fundus examination was carried out, ending up with patients’ best corrected visual acuity. Central retinal thickness (CRT) was also recorded and results were compared with prior visit results of patients. Major outcomes were the improvement in visual acuity and decrease in CRT. Baseline CRT values were also compared with post injection CRT values at one week, one month and two months intervals using paired sample t-test and best corrected visual acuity (BCVA) was compared using chi–square test. Results: Mean age of the patients was 39.6 years with a male to female ratio of 9:1. Best corrected visual acuity was 6/60 on Snellen chart at baseline. All patients exhibited mean improvement of best corrected visual acuity of three Snellen lines after one week. Eleven patients were back to best corrected visual acuity of 6/6 after one month. Remaining one patient gained best corrected visual acuity of 6/6 after two months of post injection. The mean CRT at presentation was 500 ± 80U (range; 386–580) which reduced significantly to 272 ± 52 U (range 220–338) from baseline after one month showing significant reduction (p<0.001). At the last follow-up visit, the CRT was measured 230 ± 20 U (range 220—250) which shows complete resolution of sub-retinal fluid. Conclusion: Intravitreal ranibizumab can be used for rapid absorption of sub-retinal fluid in acute CSCR and significant reduction in CRT along with improvement in BCVA indicate that it may be safely employed in CSCR to achieve better clinical outcomes.

scholarly journals Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jia Yu ◽  
Lei Li ◽  
Chunhui Jiang ◽  
Qing Chang ◽  
Gezhi Xu
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Chinese Population ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Initial Visit ◽  
Half Dose ◽  
The Mean

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.

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

2019 ◽  
Vol 104 (2) ◽  
pp. 182-187 ◽  
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.

scholarly journals The Efficacy of Intravitreal Conbercept for Chronic Central Serous Chorioretinopathy

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Jianbo Mao ◽  
Caiyun Zhang ◽  
Chenyi Liu ◽  
Lijun Shen ◽  
Jimeng Lao ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Short Term ◽  
Chronic Central Serous Chorioretinopathy ◽  
Full Resolution ◽  
Repeated Measures Analysis ◽  
Retrospective Clinical Study ◽  
The Mean

Purpose. To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods. A retrospective clinical study. Thirty-one patients (35 eyes) with chronic CSC were given intravitreal injections of conbercept and followed up for at least 6 months. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT), and resolution of subretinal fluid (SRF). Serial changes in BCVA and CMT were analyzed by using repeated measures analysis of variance. Results. During the 6-month follow-up, the mean number of injections required and performed was 1.77 ± 0.60. The logMAR BCVA was 0.48 ± 0.26 at the baseline, 0.34 ± 0.26, 0.30 ± 0.26, 0.27 ± 0.26, 0.24 ± 0.26, and 0.23 ± 0.26 at 2-week and 1-, 2-, 3-, and 6-month follow-ups, respectively (F = 27.173, P<0.05). CMT was 313.74 ± 144.51 μm at the baseline and decreased to 263.49 ± 120.44 μm, 225.91 ± 91.98 μm, 195.77 ± 66.69 μm, 189.74 ± 65.41 μm, and 199.49 ± 81.50 μm at 2-week and 1-, 2-, 3-, and 6-month follow-ups, respectively (F = 18.093, P<0.05). Full resolution of SRF was achieved in 8 (22.9%) eyes at 1 month, 16 (45.7%) eyes at 2 months, 22 (62.9%) eyes at 3 months, and 27 (77.1%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusions. Intravitreal injection of conbercept may effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months.

scholarly journals Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jay Chhablani ◽  
Gagan Kalra ◽  
Lubna Alkwatli ◽  
Bernd Fassbender ◽  
Francesca Amoroso ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Duration Of Symptoms ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.

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

2015 ◽  
Vol 234 (4) ◽  
pp. 189-194 ◽  
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.

scholarly journals Short-Term Outcomes of Cataract Surgery in Patients with a History of Central Serous Chorioretinopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jeon Young Joon ◽  
Jae Hui Kim ◽  
Jong Woo Kim ◽  
Chul Gu Kim
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Short Term ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
History Of ◽  
The Mean

Purpose. This study aimed to evaluate the short-term outcomes of cataract surgery in patients with a history of idiopathic central serous chorioretinopathy (CSC). Methods. This retrospective study included 26 patients with a history of CSC who underwent uncomplicated phacoemulsification and intraocular lens implantation. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured before the surgery were compared with those obtained at mean 3.6 months after the surgery. BCVA outcome was also analyzed in eyes with and without subretinal fluid (SRF). Results. The mean logarithm of the minimal angle of resolution BCVA significantly improved from 0.52 ± 0.40 before the surgery to 0.21 ± 0.30 one month after the surgery and 0.20 ± 0.31 at 3.6 months after the surgery ( P < 0.001 ). The mean CFT was 281.2 ± 84.2 μm before the surgery, 301.5 ± 90.7 μm one month after the surgery, and 279.9 ± 83.6 μm at 3.6 months after the surgery. The CFT before surgery was not different from those measured at 3 months ( P = 0.253 ). Significant improvement in BCVA at 3.6 months was noted in the SRF group (N = 12, P = 0.003 ) and the non-SRF group (N = 14, P = 0.001 ). CSC recurrence was noted in 2 patients in the non-SRF group. Conclusions. Significant improvement in visual acuity was noted after cataract surgery in patients with a history of idiopathic CSC, without a risk of aggravation of CSC in most patients.

scholarly journals The role of high-dose steroid therapy in Covid-19 pneumonia

2021 ◽  
Author(s):  
Ayperi Ozturk ◽  
Figen Ozturk Ergur ◽  
Suna Kavurgacı ◽  
Melahat Uzel Şener ◽  
Murat Yıldız
Keyword(s):  
Mortality Rate ◽  
Low Dose ◽  
High Dose ◽  
Efficacy And Safety ◽  
Short Term ◽  
High Dose Steroid ◽  
Younger Age ◽  
Observation Period

Introduction: Today, whereas hypoxemia and respiratory failure is the major challenging problem in the course of severe COVID-19 pneumonia, to control the disease at a mild-moderate stage or to stop the inflammation by recognizing the cytokine storm early should be the most prominent goal. We aimed to reveal the clinical efficacy and safety of short-term high-dose corticosteroids in severe COVID-19. Material and Methods: This retrospective observational study consisted of 54 patients who were given high-dose steroid (HDS (>250 mg/day methylprednisolone, 3 days.). Low-dose steroid (LDS) therapy (dexamethasone 8 mg ) was applied to all patients. HDS group was reviewed in terms of decreasing hospital mortality and preventing fibrosis development in follow-up. Results: During the observation period, out of 317 severe COVID-19 pneumonia hospitalized, HDS and LDS were administered to 54 and 216 patients, respectively. Higher body mass index, younger age, more oxygen need of patients at admission, and more need for advanced oxygen therapy during hospitalization were found in the HDS group (p<0.001). Furthermore, 18.5% of patients in the HDS group had need transfer to the intensive care unit whereas it was 3.8% in LDS (p<0.001). Additionally, the mortality rate was determined higher in the HDS group (25. 9% vs 9.9%, p<0.001). The HDS group had lower saturated O2 [IQR, 85% (76-89), p <0.001], and higher ferritin at admission. It was found that HDS was given simultaneously with the increased ferritin with deepening lymphopenia on the third and fifth days. There was no difference in fibrosis development between HDS patients receive and not (15.4% vs 26.2%, p=0.11) Conclusion: The use of HDS in hospitalized COVID-19 patients remains unclear. Along with this, our study demonstrated the use of high-dose corticosteroids might not be associated with a lower mortality rate among hospitalized severe COVID-19 patients.

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

2017 ◽  
Vol 8 (3) ◽  
pp. 568-573
Author(s):  
Tina Xirou ◽  
Stamatina A. Kabanarou ◽  
Ilias Gkizis ◽  
Christina Garnavou-Xirou ◽  
Stavros Velissaris ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Female Patient ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Ophthalmological Examination ◽  
Chronic Central Serous Chorioretinopathy ◽  
Recent Onset ◽  
The Right ◽  
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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