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Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments.
Curr Pharm Des. 2018; 24(41):4864-4873.CP

Abstract

BACKGROUND

Central serous chorioretinopathy (CSC) is the fourth most frequent retinal disorder in terms of prevalence. It typically occurs in young subjects and affects men more often than women. CSC is characterized by serous retinal detachment (SRD) involving mainly the macular area. The clinical course is usually selflimited, with spontaneous resolution within 3 months. The persistence of SRD or multiple relapse may result in a chronic form of CSC distinguished by permanent retinal pigment epithelium (RPE) and photoreceptor damage. As the pathogenetic mechanism of CSC primarily involves RPE and choroidal vascularization, the current therapeutic approaches aim to restore the normal functions of RPE and normal choroidal vascular permeability. In this review, the authors aim to summarize the current therapeutic approach to CSC.

METHODS

A comprehensive review of the literature was conducted in PubMed by searching for relevant studies on the current therapeutic options for CSC, including simple observation, conventional laser treatment, subthreshold laser treatment (SLT), photodynamic therapy (PDT) with verteporfin, treatment with mineralocorticoid receptor (MR) antagonists and treatment with anti-vascular endothelial growth factor drugs.

RESULTS

Since most cases resolve spontaneously, the most common initial CSC treatment is observation. Current evidence suggests that PDT and SLT are valuable in improving visual acuity, reducing subretinal fluid and maintaining long-term effectiveness. No clear evidence of efficacy has been achieved for anti-VEGF. MR antagonists might be a viable choice for the treatment of chronic CSC.

CONCLUSION

The pathophysiology of CSC remains poorly understood and as a consequence, the gold standard of care for CSC is yet to be defined. To date, PDT and SLT continue to offer good clinical outcomes. Positive preliminary results seem to emerge from the studies of MR antagonists.

Authors+Show Affiliations

IRCCS Fondazione Bietti, Rome, Italy.Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d'Annunzio Chieti-Pescara, Chieti, Italy.IRCCS Fondazione Bietti, Rome, Italy.IRCCS Fondazione Bietti, Rome, Italy.IRCCS Fondazione Bietti, Rome, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

30674250

Citation

Iacono, Pierluigi, et al. "Pharmacotherapy of Central Serous Chorioretinopathy: a Review of the Current Treatments." Current Pharmaceutical Design, vol. 24, no. 41, 2018, pp. 4864-4873.
Iacono P, Toto L, Costanzo E, et al. Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments. Curr Pharm Des. 2018;24(41):4864-4873.
Iacono, P., Toto, L., Costanzo, E., Varano, M., & Parravano, M. C. (2018). Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments. Current Pharmaceutical Design, 24(41), 4864-4873. https://doi.org/10.2174/1381612825666190123165914
Iacono P, et al. Pharmacotherapy of Central Serous Chorioretinopathy: a Review of the Current Treatments. Curr Pharm Des. 2018;24(41):4864-4873. PubMed PMID: 30674250.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments. AU - Iacono,Pierluigi, AU - Toto,Lisa, AU - Costanzo,Eliana, AU - Varano,Monica, AU - Parravano,Maria Cristina, PY - 2018/12/12/received PY - 2019/01/18/accepted PY - 2019/1/25/pubmed PY - 2019/11/22/medline PY - 2019/1/25/entrez KW - Central serous chorioretinopathy KW - anti-VEGF KW - eplerenone KW - laser photocoagulation KW - photodynamic therapy KW - subthreshold laser treatment KW - verteporfin. SP - 4864 EP - 4873 JF - Current pharmaceutical design JO - Curr. Pharm. Des. VL - 24 IS - 41 N2 - BACKGROUND: Central serous chorioretinopathy (CSC) is the fourth most frequent retinal disorder in terms of prevalence. It typically occurs in young subjects and affects men more often than women. CSC is characterized by serous retinal detachment (SRD) involving mainly the macular area. The clinical course is usually selflimited, with spontaneous resolution within 3 months. The persistence of SRD or multiple relapse may result in a chronic form of CSC distinguished by permanent retinal pigment epithelium (RPE) and photoreceptor damage. As the pathogenetic mechanism of CSC primarily involves RPE and choroidal vascularization, the current therapeutic approaches aim to restore the normal functions of RPE and normal choroidal vascular permeability. In this review, the authors aim to summarize the current therapeutic approach to CSC. METHODS: A comprehensive review of the literature was conducted in PubMed by searching for relevant studies on the current therapeutic options for CSC, including simple observation, conventional laser treatment, subthreshold laser treatment (SLT), photodynamic therapy (PDT) with verteporfin, treatment with mineralocorticoid receptor (MR) antagonists and treatment with anti-vascular endothelial growth factor drugs. RESULTS: Since most cases resolve spontaneously, the most common initial CSC treatment is observation. Current evidence suggests that PDT and SLT are valuable in improving visual acuity, reducing subretinal fluid and maintaining long-term effectiveness. No clear evidence of efficacy has been achieved for anti-VEGF. MR antagonists might be a viable choice for the treatment of chronic CSC. CONCLUSION: The pathophysiology of CSC remains poorly understood and as a consequence, the gold standard of care for CSC is yet to be defined. To date, PDT and SLT continue to offer good clinical outcomes. Positive preliminary results seem to emerge from the studies of MR antagonists. SN - 1873-4286 UR - https://www.unboundmedicine.com/medline/citation/30674250/Pharmacotherapy_of_Central_Serous_Chorioretinopathy:_A_Review_of_the_Current_Treatments_ L2 - http://www.eurekaselect.com/169299/article DB - PRIME DP - Unbound Medicine ER -