Central serous chorioretinopathy
The development of secondary blood vessels, so-called choroidal neovascularization (CNV) leads to pachychoroid neovasculopathy (PNV).An oft-cited but potentially inaccurate conclusion is that persons in stressful occupations, such as airplane pilots, have a higher incidence of CSR.[1] The available evidence suggests that half-dose (or half-fluence) photodynamic therapy is the treatment of choice for CSR with subretinal fluid for longer than 3–4 months.[20] Due to the natural disease course of CSR - in which spontaneous resolution of subretinal fluid may occur - retrospective studies may erroneously report positive treatment outcomes and should, therefore, be evaluated with caution.[23] In the PLACE trial, half-dose photodynamic therapy was found to be superior compared to high-density subthreshold micropulse laser, both with regard to anatomical and functional outcomes.[1] In chronic cases, transpupillary thermotherapy has been suggested as an alternative to laser photocoagulation where the leak is in the central macula.In a retrospective study noted by Acta Ophthalmologica, spironolactone improved visual acuity in CSR patients over the course of 8 weeks.In a study noted in International Journal of Ophthalmology, results showed Epleronone decreased the subretinal fluid both horizontally and vertically over time.[30] However, a large investigator-initiated randomized controlled trial (VICI) showed that eplerenone has no significant effect on chronic CSR.The nonsteroidal topical medications that are sometimes used to treat CSR are, ketorolac, diclofenac, or bromfenac, but the level of evidence to support their use is limited.[34] Lasting problems include decreased night vision, reduced color discrimination, and localized distortion caused by scarring of the sub-retinal layers.There is also a chronic form, titled as type II central serous retinopathy, which occurs in approximately 5% of cases.
fovea centralisoptical coherence tomographySpecialtyOphthalmologyeye diseasevisual impairmentmetamorphopsiavisual acuitystresscorticosteroidpachychoroid spectrumchoroidvascularizedblood vesselcapillariesretinal pigment epitheliumchoroidal neovascularizationaneurysmspolypoidal choroidal vasculopathyidiopathiccortisolhormoneadrenal cortexcorticosteroidscortisoneCushing's syndromesympathomimetic drugshelicobacter pylorigastritisglomerular basement membraneIndocyanine greenlaser Doppler imagingdilated examinationfluorescein angiographyretinal detachmentrefractive spectacle prescriptionfar-sightedfocal lengthIndocyanine green angiographyphotodynamic therapyverteporfinLaser photocoagulationCochrane reviewSpironolactoneEplerenonerandomized controlled trialtype A personalitiessleep apneasystemic hypertensionnight visionscarringsub-retinal layerssubretinal neovascularizationDiabetic retinopathyGeographic atrophyHypertensive retinopathyMacular degenerationPosterior vitreous detachmentGuymer RBibcodeDiseasesDBMedlinePluseMedicineDiseases of the human eyeAdnexaEyelidChalazionBlepharitisMeibomian gland dysfunctionEntropionEctropionLagophthalmosBlepharochalasisPtosisBlepharophimosisXanthelasmaAnkyloblepharonEyelashTrichiasisMadarosisDistichiasisTrichomegalyLacrimal apparatusDacryoadenitisEpiphoraDacryocystitisXerophthalmiaExophthalmosEnophthalmosOrbital cellulitisOrbital lymphomaPeriorbital cellulitisConjunctivaChemosisConjunctivitisallergicPterygiumPseudopterygiumPingueculaSubconjunctival hemorrhageFibrous tunicScleraScleritisEpiscleritisCorneaKeratitisherpeticacanthamoebicfungalExposurePhotokeratitisCorneal ulcerThygeson's superficial punctate keratopathyCorneal dystrophyFuchs'MeesmannCorneal ectasiaKeratoconusPellucid marginal degenerationKeratoglobusTerrien's marginal degenerationPost-LASIK ectasiaKeratoconjunctivitisCorneal opacityCorneal neovascularizationKayser–Fleischer ring