2020–2021 BCSC Basic and Clinical Science Course™
12 Retina and Vitreous
Part II: Disorders of the Retina and Vitreous
Chapter 09: Choroidal Disease
Central Serous Chorioretinopathy
CSC is destructive and therefore can cause visually significant scotomas. Secondary CNV occurs in the immediate postoperative period in up to 2% of eyes that have been treated with photocoagulation. Laser photocoagulation is not associated with a reduced rate of recurrence. Verteporfin photodynamic therapy (PDT) reduces or eliminates subretinal fluid and is associated with few complications, the most common of which is atrophy, which occurs in about 4% of treated eyes. Recurrence after successful PDT is rare. Laser photocoagulation has no effect on choroidal thickness, while PDT decreases choroidal thickness and reduces choroidal vascular hyperpermeability. Use of mineralocorticoid receptor antagonists such as eplerenone or spironolactone is associated with resolution of subretinal fluid in about 25% of treated patients, but this therapy has not been the subject of a randomized trial.
Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010;117(9):1792–1799.
Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy. Retina. 2013;33(8): 1659–1672.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.