scholarly journals The effect of selective retina therapy for bevacizumab-resistant chronic central serous chorioretinopathy

2021 ◽  
Author(s):  
Seung Hee Jeon ◽  
Minhee Kim ◽  
Jiyoung Lee ◽  
Young-Jung Roh
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Retrospective Cohort ◽  
Subretinal Fluid ◽  
Treatment Results ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Selective Retina Therapy ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Anatomical Outcomes

Purpose: To evaluate the efficacy of selective retina therapy (SRT), used in conjunction with real-time feedback dosimetry (RFD), in the treatment of bevacizumab-resistant chronic central serous chorioretinopathy (CSC). Patients and Methods: In this retrospective cohort study, 22 eyes of 22 patients with anti-VEGF-resistant chronic CSC, showing focal or diffuse foveal leakages on fundus fluorescein angiography (FFA), were included. After evaluation of the test spots at temporal arcades, SRT (wavelength, 527 nm; pulse repetition rate, 100 Hz; ramping over maximal 15 micropulses; and spot diameter, 200 µm) using RFD was applied to the leakage sites observed on FFA. Changes in the mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 1, 3, 6, 9, and 12 months following treatment. Results: SRF completely resolved in 81.8% (18/22 eyes) cases at 12-months post-treatment. The mean BCVA (logMAR) improved from 0.49 ± 0.29 at baseline to 0.43 ± 0.36 at 12 months (p = 0.067). The mean BCVA gain was 0.06 logMAR, equivalent to 3 ETDRS letters. The CMT significantly decreased from 323 ± 85.6 µm at baseline to 221.5 ± 60.4 µm at 12 months (p < 0.001). The mean SRF height also significantly decreased from 174.6 ± 86.4 µm at baseline to 35.1 ± 75.4 µm at 12 months (p < 0.001). Conclusion: SRT showed favorable visual and anatomical outcomes in patients with bevacizumab-resistant chronic CSC.

scholarly journals Factors Predicting Response to Selective Retina Therapy in Patients with Chronic Central Serous Chorioretinopathy

2022 ◽  
Vol 11 (2) ◽  
pp. 323
Author(s):  
Minhee Kim ◽  
Seung Hee Jeon ◽  
Ji-young Lee ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Central Macular Thickness ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Safety And Efficacy ◽  
Selective Retina Therapy ◽  
Corrected Visual Acuity ◽  
Anatomical Outcomes ◽  
Best Corrected Visual Acuity

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.

scholarly journals Title Spironolactone for chronic central serous chorioretinopathy - a pilot study

2019 ◽  
Author(s):  
Xiaoli Yu ◽  
Juanjuan Tang ◽  
Yu Song ◽  
Xin Cao ◽  
Tianwei Qian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pilot Study ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Subretinal Fluid ◽  
Mineralocorticoid Receptors ◽  
High Permeability ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
The Mean

Abstract AIM To estimate the efficacy of oral spironolactone in patients with chronic central serous chorioretinopathy (CSC). METHODS This was a pilot study consisting of patients who were diagnosed with chronic central serous chorioretinopathy for at least a 6-month duration. This study included 75 eyes of 74 patients who were treated with spironolactone (20 mg orally, twice daily) for 8 weeks. The best corrected visual acuity (BCVA), subretinal fluid (SRF), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were each measured at baseline, 4 weeks and 8 weeks. RESULTS In our study, 75 eyes of 74 patients (49 men and 25 women) were included. The mean BCVA was 0.39 ± 0.25 at baseline, 0.29 ± 0.19 at 4 weeks and 0.23 ± 0.19 at 8 weeks. The BCVA at 4 weeks and 8 weeks was significantly improved compared to the baseline BCVA (p = 0.000). The mean SRF and the mean CMT decreased significantly at 4 weeks and 8 weeks (p = 0.000). The mean SFCT decreased slightly at 4 weeks and 8 weeks but without significance compared to the baseline (p = 0.654). CONCLUSION Spironolactone can competitively bind to mineralocorticoid receptors (MRs), reduce glucocorticoid binding or reduce endogenous activation of MR. It is possible to improve the visual acuity and safety of patients with chronic CSC by reducing the high permeability of the choroid membrane and by promoting the absorption of the subretinal fluid.

scholarly journals Functional and morphological retinal impairment following resolved chronic central serous chorioretinopathy

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

scholarly journals The Effect of Selective Retina Therapy with Automatic Real-Time Feedback-Controlled Dosimetry for Chronic Central Serous Chorioretinopathy: A Randomized, Open-Label, Controlled Clinical Trial

2021 ◽  
Vol 10 (19) ◽  
pp. 4295
Author(s):  
Ji-young Lee ◽  
Min-hee Kim ◽  
Seung-hee Jeon ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Real Time ◽  
Central Serous Chorioretinopathy ◽  
Controlled Trial ◽  
Subretinal Fluid ◽  
Post Treatment ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Chronic Central Serous Chorioretinopathy ◽  
Selective Retina Therapy

This prospective randomized controlled trial evaluated the safety and efficacy of real-time feedback-controlled dosimetry (RFD)-guided selective retina therapy (SRT) in chronic central serous chorioretinopathy (CSC). Forty-four participants with chronic CSC were included and randomly assigned to the control group or SRT group. The SRT laser system with RFD-guidance was applied to cover the entire leakage area. If SRF remained at the 6-week follow-up visit, re-treatment and rescue SRT was performed for the SRT group and crossover group, respectively. The rate of complete resolution of subretinal fluid (SRF), mean SRF height, and mean retinal sensitivity were compared between the two groups at 6-weeks post-treatment. The complete SRF resolution rate in all SRT-treated eyes was evaluated at 12-weeks post-treatment. The rate of complete SRF resolution was significantly higher in the SRT group (63.6%) than in the control group (23.8%) at 6-weeks post-treatment (p = 0.020). The mean SRF height at 6 weeks after SRT was significantly lower in the SRT group (p = 0.041). Overall, SRT-treated eyes showed complete SRF resolution in 70.3% of eyes at 12-weeks post-treatment. RFD-guided SRT was safe and effective to remove SRF in chronic CSC patients during the 3-month follow-up period.

Chronic Central Serous Chorioretinopathy; Signs, Diagnosis and Treatment

2020 ◽  
pp. 104-111
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Fluid Accumulation ◽  
Fundus Fluorescein Angiography ◽  
Blurred Vision ◽  
Chronic Central Serous Chorioretinopathy

Central serous chorioretinopathy (CSCR) is a maculopathy characterized by the separation of the neurosensory layer as a result of fluid accumulation between the retinal pigment epithelium (RPE) and the photoreceptor layer. Classically it is classified as acute and chronic forms. When the disease lasts longer than 4-6 months, it is called a chronic form and comprises 15% of all CSCR cases. Although the exact etiology is unknown; studies emphasize changes in choroidal circulation causing choroidal ischemia and vascular hyperpermeability as well as subretinal fluid accumulation due to deterioration pump function of RPEs. Subretinal fluid accumulation can lead to photoreceptor dysfunction and loss of vision. Classical findings in patients are a decrease in visual acuity, blurred vision, metamorphopsia, micropsia, disturbance in color vision and dark adaptation, and scotomas. Diagnosis and follow-up depend on fundoscopy as well as imaging. Optical coherent tomography is the primary method. Fundus autofluorescence (FAF) is useful in defining RPE changes noninvasively. Fundus fluorescein angiography (FFA) shows the source of leakage. In recurrent, unresolved and chronic cases, OCT, FAF, FFA, and indocyanine green angiography can be used all together to manage the disease, to follow-up its extension, and to diagnose possible neovascular as well as polypoidal component. For the treatment of chronic CSCR patients, besides medical treatments such as carbonic anhydrase inhibitors, mineralocorticoid receptor, and glucocorticoid antagonists and intravitreal vascular endothelial growth factor antagonist (Anti-VEGF) injections, half-dose photodynamic therapy and subthreshold micropulse laser treatment are used. Prospective, controlled trials with large series for the treatment of chronic CSCR warranted.

Eplerenone for treatment of chronic central serous chorioretinopathy

2020 ◽  
pp. 112067212095264 ◽  
Author(s):  
Doris Fraenkel ◽  
Shady Suffo ◽  
Achim Langenbucher ◽  
Berthold Seitz ◽  
Alaa Din Abdin
Keyword(s):  
Visual Acuity ◽  
Treatment Response ◽  
Central Serous Chorioretinopathy ◽  
Life Experience ◽  
Real Life ◽  
Subretinal Fluid ◽  
Macular Thickness ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To assess the morphological and functional outcome of oral eplerenone for treatment of patients with chronic central serous chorioretinopathy (CSC) in a real life experience. Patients and methods: In this retrospective study, we reviewed the clinical files of 30 patients with chronic CSC. All patients were treated with eplerenone for a period of 6 weeks or 3 months depending on the clinical response. Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT) and height of the subretinal fluid (SRF). Comparisons between responders and non-responders were performed to identify factors that were predictive of the treatment response. Results: All patients were treated with eplerenone 18 ± 20 weeks after onset of the first symptoms. BCVA (LogMAR) improved from 0.2 ± 0.2 to 0.13 ± 0.18 at 6 weeks ( p = 0.01) and to 0.09 ± 0.15 at 3 months ( p = 0.01). Mean CMT decreased from 409 ± 136 to 323 ± 87 µm at 6 weeks ( p = 0.001) and to 298 ± 98 µm at 3 months ( p = 0.01). Mean height of SRF decreased from 153 ± 126 to 73 ± 79 µm at 6 weeks ( p = 0.001) and to 49 ± 88 µm at 3 months ( p = 0.005). Complete resolution of SRF was achieved in 20 patients after 3 months (67%). Reported stress in the medical history was the only statistical significant predictive factor associated with a positive treatment response. Conclusion: This study showed a statistically significant improvement of the best corrected visual acuity and a significant reduction of macular thickness and subretinal fluid in patients with chronic CSC treated with oral eplerenone, especially in patients under stress.

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 Factors Affecting Resolution of Subretinal Fluid After Selective Retina Therapy for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Manabu Yamamoto ◽  
Akika Kyo ◽  
Kumiko Hirayama ◽  
Takeya Kohno ◽  
Dirk Theisen-Kunde ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Rate Of Change ◽  
Factors Affecting ◽  
Selective Retina Therapy ◽  
Significant Difference ◽  
The Mean

Abstract The purpose of this study was to investigate the factors of clinical outcome of selective retina therapy (SRT) for central serous chorioretinopathy (CSC). This retrospective study included 77 eyes of 77 patients, who were treated with SRT for CSC and observed at least 6 months after the treatment. SRT laser (527 nm, 1.7 µs, 100 Hz) was used for treatment. The mean best-corrected visual acuity (BCVA) (logMAR), central macular thickness (CMT) and central choroidal thickness were changed from baseline to at 6-months follow-up with significant difference. The multivariate analyses found that the rate of change (reduction) in CMT was associated with focal leakage type on fluorescein angiography (FA) (p = 0.03, coefficient 15.26, 95% confidence interval 1.72 – 28.79) and larger baseline CMT (p < 0.01, coefficient -0.13, 95% confidence interval -0.13 – -0.05). Complete resolution of subretinal fluid was associated with nonsmoking history (p = 0.03, odds ratio 0.276, 95% confidence interval 0.086 – 0.887) and focal leakage type on FA (p < 0.01, odds ratio 0.136, 95% confidence interval 0.042 – 0.437). This result may be useful for predicting the therapeutic effectiveness of SRT.

Treatment of resistant chronic central serous chorioretinopathy via platelet-rich plasma with electromagnetic stimulation

2020 ◽  
Author(s):  
Umut Arslan ◽  
Emin Özmert
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Platelet Rich Plasma ◽  
Chronic Central Serous Chorioretinopathy ◽  
Electromagnetic Stimulation ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
Subtenon Injection ◽  
The Mean ◽  
Best Corrected Visual Acuity

Background: To evaluate whether subtenon injection of platelet-rich plasma (PRP) with retinal electromagnetic stimulation (rEMS) is effective in therapy-resistant chronic central serous chorioretinopathy (CSCR). Design: Prospective, sequential. Materials & methods: The study included 22 eyes with resistant chronic CSCR. Cases receiving micropulse laser or additional photodynamic therapy, subtenon PRP, and subtenon PRP + rEMS were classified as times 1, 2 and 3, respectively. Results: At time 3, the mean best-corrected visual acuity was 85.7 and 97.0 letters before and after the procedures, respectively (p = 0.01). Submacular thickness improved by 17, 27 and 51% at times 1, 2 and 3 respectively. Conclusion: For treating resistant CSCR, subtenon PRP + rEMS should be considered as an effective and safe option. Trial Registration: ClinicalTrials.gov ID: NCT04224831

scholarly journals Efficacy of oral rifampicin in chronic central serous chorioretinopathy

2018 ◽  
Vol 10 ◽  
pp. 251584141880713 ◽  
Author(s):  
Ramesh Venkatesh ◽  
Manisha Agarwal ◽  
Meha Kantha
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Duration Of Symptoms ◽  
Diffuse Retinal Pigment Epitheliopathy

Objective: To evaluate the role of oral rifampicin in the management of chronic central serous chorioretinopathy. Methods: Retrospective analysis of patients diagnosed with chronic central serous chorioretinopathy (duration >3 months) and treated with oral rifampicin 600 mg daily for a maximum period of 3 months was carried out. Baseline visual acuity, fundus fluorescein angiography, and optical coherence tomography were recorded and the patients were followed up. Resolution of subretinal fluid and improvement in visual acuity were the main outcome measures. Recurrence of subretinal fluid was noted. Any adverse reaction to the drug was monitored. Results: Nine eyes of eight patients were included in the study. The average age of the patients was 41.90 years (range 32–52 years). Mean duration of symptoms was 16 months (range 3–60 months). Mean duration of follow-up was 10.11 months (range 3–33 months). Fluorescein angiography showed four eyes with subfoveal leaks and five eyes with diffuse retinal pigment epitheliopathy. Complete resolution of subretinal fluid was achieved in four of the nine eyes – two patients at the end of 1 month, one patient each at the end of 2 and 3 months, respectively. Visual acuity improvement was noted in four of the nine eyes. Three patients had one-line improvement and one patient had a two-line visual improvement. None of the patients had severe adverse events for which the drug had to be discontinued. None of the patients had recurrence of subretinal fluid after the discontinuation of the drug. Conclusion: Oral rifampicin could provide a useful, effective, and cost-effective alternative for treatment of patients with chronic central serous choroidopathy and evidence of healthier retinal pigment epithelium, those with focal leakage. It was not effective in eyes with diffuse retinal pigment epitheliopathy.

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