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CSCR (Central Serous Chorioretinopathy)

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Albert and Jakobiec's Principles and Practice of Ophthalmology

Abstract

Central serous chorioretinopathy (CSC) is characterized by an idiopathic circumscribed serous retinal detachment, usually confined to the central macula, caused by leakage of fluid through the retinal pigment epithelium as defined by fluorescein angiography. Eyes with CSC do not have signs of intraocular inflammation, accelerated hypertension, infiltration or infarction of the choroid, or retinal pigment epithelium. Serous detachments of the RPE are frequently present. Although most cases are acute with minimal sequela, some patients have a more chronic version of the disease with poorer visual prognosis.

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References

  1. von Graefe A. Ueber centrale recidivierende retinitis. Graefes Arch Clin Exp Ophthalmol. 1866;12:211–5.

    Article  Google Scholar 

  2. Horniker E. Su di una forma retinite centrale di origine vasoneurotica (retinite central capillaro spastica). Ann Ottal. 1927;55:578–600.

    Google Scholar 

  3. Gifford SR, Marquardt G. Central angiospastic retinopathy. Arch Ophthalmol. 1939;21:211–28.

    Article  Google Scholar 

  4. Bennett G. Central serous retinopathy. Br J Ophthalmol. 1955;39:605–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Maumenee AE. Symposium: macular diseases, clinical manifestations. Trans Am Acad Ophthalmol Otolaryngol. 1965;69:605–13.

    CAS  PubMed  Google Scholar 

  6. Gass JDM. Pathogenesis of disciform detachment of the neuroepithelium. II. Idiopathic central serous choroidopathy. Am J Ophthalmol. 1967;63:587–615.

    Google Scholar 

  7. Yannuzzi L, Shakin J, Fisher Y, et al. Peripheral retinal detachment and retinal pigment epithelial atrophic tracts secondary to central serous pigment epitheliopathy. Ophthalmology. 1984;91:1554–72.

    Article  CAS  PubMed  Google Scholar 

  8. Spaide RF. Central serous chorioretinopathy and other causes of serous detachment of the retina. In: Spaide RF, editor. Diseases of the retina and vitreous. Philadelphia: W.B. Saunders Co; 1999.

    Google Scholar 

  9. Spitznas M, Huke J. Number, shape, and topography of leakage points in acute type I central serous retinopathy. Graefes Arch Clin Exp Ophthalmol. 1987;225:438–40.

    Google Scholar 

  10. Gilbert CM, Owens SL, Smith PD, Fine SL. Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol. 1984;68:815–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Spaide RF, Campeas L, Haas A, et al. Central serous chorioretinopathy in younger and older adults. Ophthalmology. 1996;103:2070–80.

    Article  CAS  PubMed  Google Scholar 

  12. Tittl MK, Spaide RF, Wong D, et al. Systemic and ocular findings in central serous chorioretinopathy. Am J Ophthalmol. 1999;128:63–8.

    Article  CAS  PubMed  Google Scholar 

  13. Haimovici R, Koh S. Gagnon DR Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004;111:244–9.

    Article  PubMed  Google Scholar 

  14. Mehta PH, Chhablani J, Wang J, et al. Central serous chorioretinopathy in African Americans at Wilmer Eye Institute. J Natl Med Assoc. 2018;110(3):297–302.

    Article  PubMed  Google Scholar 

  15. Desai UR, Alhalel AA, Campen TJ, et al. Central serous chorioretinopathy in African Americans. J Natl Med Assoc. 2003;95:553–9.

    PubMed  PubMed Central  Google Scholar 

  16. Spitznas M. Central serous retinopathy. In: Ryan SJ, editor. Retina. St. Louis: CV Mosby; 1989. p. 217–27.

    Google Scholar 

  17. Gass JDM. Central serous chorioretinopathy and white subretinal exudation during pregnancy. Arch. Ophthalmol. 1991;109:677.

    Article  CAS  PubMed  Google Scholar 

  18. Karadimas P, Bouzas EA. Glucocorticoid use represents a risk factor for central serous chorioretinopathy: a prospective, case-control study. Graefes Arch Clin Exp Ophthalmol. 2004;242(9):800.

    Article  CAS  PubMed  Google Scholar 

  19. Polak BC, Baarasma GS, Snyers B. Diffuse retinal pigment epitheliopathy complicating systemic corticosteroid treatment. Br J Ophthalmol. 1995;79:922–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Gass JD, Little H. Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy. Ophthalmology. 1995;102:737–47.

    Article  CAS  PubMed  Google Scholar 

  21. Gass JDM, Slamovits TL, Fuller DG, Gieser RG, Lean JS. Posterior chorioretinopathy and retinal detachment after organ transplantation. Arch Ophthalmol. 1992;110:1717–22.

    Article  CAS  PubMed  Google Scholar 

  22. Iida T, Spaide RF, Haas A, et al. Leopard-spot pattern of yellowish subretinal deposits in central serous chorioretinopathy. Arch Ophthalmol. 2002;120:37–42.

    Article  PubMed  Google Scholar 

  23. Haimovici R, Gragoudas E, Duker J, et al. Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids. Ophthalmol. 1997;104:1653–60.

    Article  CAS  Google Scholar 

  24. Fernandez C, Mendoza A, Arevola J. Central serous chorioretinopathy associated with topical dermal corticosteroids. Retina. 2004;24:471–4.

    Article  PubMed  Google Scholar 

  25. Karadimas P, Kapetanios A, Bouzas E. Central serous chorioretinopathy after local application of glucocorticoids for skin disorders. Arch Ophthalmol. 2004;122:784–6.

    Article  PubMed  Google Scholar 

  26. Williamson J, Nuki G. Macular lesions during systemic therapy with depot tetracosactrin. Br J Ophthalmol. 1970;54:405–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Imasawa M, Ohshiro T, Gotoh T, et al. Central serous chorioretinopathy following vitrectomy with intravitreal triamcinolone acetonide for diabetic macular oedema. Acta Ophthalmol Scand. 2005;83:132–3.

    Article  PubMed  Google Scholar 

  28. Baumal C, Martidis A, Truong S. Central serous chorioretinopathy associated with periocular corticosteroid injection treatment for HLA-B27-associated iritis. Arch Ophthalmol. 2004;122:926–8.

    Article  PubMed  Google Scholar 

  29. Haimovici R, Rumelt S, Melby J. Endocrine abnormalities in patients with central serous chorioretinopathy. Ophthalmology. 2003;110:698–703.

    Article  PubMed  Google Scholar 

  30. Yoshioka H, Katsume Y, Akune H. Experimental central serous chorioretinopathy in monkey eyes: fluorescein angiographic findings. Ophthalmologica. 1982;185:168–78.

    Article  CAS  PubMed  Google Scholar 

  31. Yoshioka H, Katsume Y. Experimental central serous chorioretinopathy. III: ultrastructural findings. Jpn J Ophthalmol. 1982;26(4):397–409.

    CAS  PubMed  Google Scholar 

  32. Michael JC, Pak J, Pulido J, de Venecia G. Central serous chorioretinopathy associated with administration of sympathomimetic agents. Am J Ophthalmol. 2003;136:182–5.

    Article  CAS  PubMed  Google Scholar 

  33. Pierce KK, Lane RG. Central serous chorioretinopathy associated with the use of ephedra. Retin Cases Brief Rep. 2009;3(4):376–8.

    Article  PubMed  Google Scholar 

  34. Hassan L, Carvalho C, Yannuzzi LA, et al. Central serous chorioretinopathy in a patient using methylenedioxymethamphetamine (MDMA) or “ecstasy”. Retina. 2001;21(5):559–61.

    Article  CAS  PubMed  Google Scholar 

  35. Gelber GS, Schatz H. Loss of vision due to central serous chorioretinopathy following psychological stress. Am J Psychiatry. 1987;144:46–50.

    Article  CAS  PubMed  Google Scholar 

  36. Yannuzzi L. Type A behavior and central serous chorioretinopathy. Trans Am Ophthalmol Soc. 1986;84:799–845.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Werry H, Arends C. Untersuchung zur Objektivierung von Personlichkeitsmerkmalen bei Patienten mit Retinopathia centralis serosa. Klin Monatsbl Augenheilkd. 1978;172:363–70.

    CAS  PubMed  Google Scholar 

  38. Yoon WJ, Na KS, Choi GJ. A study on objective personality characteristics of the central serous chorioretinopathy patients. J Korean Ophthalmol Soc. 1997;38:1155–61.

    Google Scholar 

  39. Ji Y, Li M, Zhang X, et al. Poor sleep quality is the risk factor for central serous chorioretinopathy. J Ophthalmol. 2018;2018:9450297.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bousquet E, Dhundass M, Lehmann M, et al. Shift work: a risk factor for central serous chorioretinopathy. Am J Ophthalmol. 2016;165:23–8.

    Article  PubMed  Google Scholar 

  41. Shimizu K, Tobari I. Central serous retinopathy dynamics of subretinal fluid. Mod Probl Ophthalmol. 1971;9:152–7.

    Google Scholar 

  42. Vukojevic N, Sikic J, Katusic D, et al. Types of central serous retinopathy, analysis of shape, topographic distribution and number of leakage sites. Coll Antropol. 2001;25(Suppl):83–7.

    PubMed  Google Scholar 

  43. Prunte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy. Am J Ophthalmol. 1996;121:26–34.

    Article  CAS  PubMed  Google Scholar 

  44. Okushiba U, Takeda M. Study of choroidal vascular lesions in central serous chorioretinopathy using indocyanine green angiography. Nippon Ganka Gakkai Zasshi. 1997;101:74–82.

    CAS  PubMed  Google Scholar 

  45. Spaide RF, Hall L, Haas A, et al. Indocyanine green videoangiography of central serous chorioretinopathy in older adults. Retina. 1996;16:78–80.

    Article  PubMed  Google Scholar 

  46. Spaide RF, Klancnik JM Jr. Fundus autofluorescence and central serous chorioretinopathy. Ophthalmology. 2005;112(5):825–33.

    Article  PubMed  Google Scholar 

  47. Spaide R. Autofluorescence from the outer retina and subretinal space: hypothesis and review. Retina. 2008;28(1):5–35.

    Article  PubMed  Google Scholar 

  48. von Rűckmann A, Fitzke F, Fan J, et al. Abnormalities of fundus autofluorescence in central serous retinopathy. Am J Ophthalmol. 2002;133:780–6.

    Article  Google Scholar 

  49. Framme C, Walter A, Gabler B, et al. Fundus autofluorescence in acute and chronic-recurrent central serous chorioretinopathy. Acta Ophthalmol Scand. 2005;83:161–7.

    Article  PubMed  Google Scholar 

  50. Spaide R. Autofluorescence from the outer retina and subretinal space: hypothesis and review. Retina. 2008;28(1):5–35.

    Article  PubMed  Google Scholar 

  51. Imamura Y, Fujiwara T, Spaide RF. Fundus autofluorescence and visual acuity in central serous chorioretinopathy. Ophthalmology. 2011;118(4):700–5.

    Article  PubMed  Google Scholar 

  52. Akiyama K, Kawamura M, Ogata T, Tanaka E. Retinal vascular loss in idiopathic central serous chorioretinopathy with bullous retinal detachment. Ophthalmology. 1987;94:1605–9.

    Article  CAS  PubMed  Google Scholar 

  53. Gass JDM. Bullous retinal detachment: an unusual manifestation of idiopathic central serous choroidopathy. Am. J. Ophthalmol. 1973;75:810.

    Article  CAS  PubMed  Google Scholar 

  54. Tsukahara I, Uyama M. Central serous choroidopathy with bullous retinal detachment. Abrecht Von Graefes Arch Klin Exp Ophthalmol. 1978;206:169–78.

    Article  CAS  Google Scholar 

  55. Otsuka S, Ohba N, Nakao K. A long-term follow-up study of severe variant of central serous chorioretinopathy. Retina. 2002;22:25–32.

    Article  PubMed  Google Scholar 

  56. Friberg TR, Eller AW. Serous retinal detachment resembling central serous chorioretinopathy following organ transplantation. Graefes Arch Clin Exp Ophthalmol. 1990;228:305–9.

    Article  CAS  PubMed  Google Scholar 

  57. Eandi CM, Chung JE, Cardillo-Piccolino F, et al. Optical coherence tomography in unilateral resolved central serous chorioretinopathy. Retina. 2005;25:417–21.

    Article  PubMed  Google Scholar 

  58. Imamura Y, Fujiwara T, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009;29(10):1469–73.

    Article  PubMed  Google Scholar 

  59. Spaide RF, Ryan EH Jr. Loculation of fluid in the posterior choroid in eyes with central serous chorioretinopathy. Am J Ophthalmol. 2015;160(6):1211–6.

    Article  PubMed  Google Scholar 

  60. Levine R, Brucker AJ, Robinson F. Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography. Ophthalmology. 1989;96(6):854–9.

    Article  CAS  PubMed  Google Scholar 

  61. Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy. Retina. 2013;33(8):1659–72.

    Article  PubMed  Google Scholar 

  62. Lee WK, Baek J, Dansingani KK, et al. Choroidal morphology in eyes with polypoidal choroidal vasculopathy and normal or subnormal subfoveal choroidal thickness. Retina. 2016;36(Suppl 1):S73–82.

    Article  PubMed  Google Scholar 

  63. Mrejen S, Balaratnasingam C, Kaden TR, et al. Long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy. Ophthalmology. 2019;126(4):576–88.

    Article  PubMed  Google Scholar 

  64. Hage R, Mrejen S, Krivosic V, et al. Flat irregular retinal pigment epithelium detachments in chronic central serous chorioretinopathy and choroidal neovascularization. Am J Ophthalmol. 2015;159(5):890–903.e3.

    Article  PubMed  Google Scholar 

  65. Sato T, Kishi S, Watanabe G, et al. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy. Retina. 2007;27(5):589–94.

    Article  PubMed  Google Scholar 

  66. Spaide RF. Disease expression in nonexudative age-related macular degeneration varies with choroidal thickness. Retina. 2018;38(4):708–16.

    Article  PubMed  Google Scholar 

  67. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease. Retina. 2011;31(3):510–7.

    Article  PubMed  Google Scholar 

  68. Sobol EK, Francis JH, Abramson DH, et al. Subfoveal choroidal thickness and vascular architecture in fellow eyes of patients with circumscribed choroidal hemangioma. Retina. 2020;40(4):758–64.

    Article  PubMed  Google Scholar 

  69. Negi A, Marmor MF. The resorption of subretinal fluid after diffuse damage to the retinal pigment epithelium. Invest Ophthalmol Vis Sci. 1983;24:1475–9.

    CAS  PubMed  Google Scholar 

  70. Marmor MF. New hypotheses on the pathogenesis and treatment of serous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1988;226:548–52.

    Article  CAS  PubMed  Google Scholar 

  71. Hayashi K, Hasegawa Y, Tokoro T. Indocyanine green angiography of central serous chorioretinopathy. Int Ophthalmol. 1986;9:37–41.

    Article  CAS  PubMed  Google Scholar 

  72. Scheider A, Nasemann JE, Lund OE. Fluorescein and indocyanine green angiographies of central serous choroidopathy by scanning laser ophthalmoscopy. Am J Ophthalmol. 1993;115:50–6.

    Article  CAS  PubMed  Google Scholar 

  73. Piccolino FC, Borgia L. Central serous chorioretinopathy and indocyanine green angiography. Retina. 1994;14:231–42.

    Article  CAS  PubMed  Google Scholar 

  74. Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D. Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol. 1994;112:1057–62.

    Article  CAS  PubMed  Google Scholar 

  75. Nagayoski K. Experimental study of chorioretinopathy by intravenous injection of adrenaline. Acta Soc Ophthalmol Jpn. 1971;75:1720–7.

    Google Scholar 

  76. Miki T, Sunada I, Higaki T. Studies on chorioretinitis induced in rabbits by stress (repeated administration of epinephrine). Acta Soc Ophthalmol Jpn. 1972;75:1037–45.

    Google Scholar 

  77. Yasuzumi T, Miki T, Sugimoto K. Electron microscopic studies of epinephrine choroiditis in rabbits. I. Pigment epithelium and Bruch’s membrane in the healed stage. Acta Soc Ophthalmol Jpn. 1974;78:588–98.

    CAS  Google Scholar 

  78. Yoshioka H, Sugita T, Nagayoski K. Fluorescein angiography findings in experimental retinopathy produced by intravenous adrenaline injection. Folia Ophthalmol Jpn. 1970;21:648–52.

    CAS  Google Scholar 

  79. Klein ML, van Buskirk EM, Friedman E, et al. Experience with nontreatment of central serous choroidopathy. Arch Ophthalmol. 1974;91:247–50.

    Article  CAS  PubMed  Google Scholar 

  80. Avci R, Deutman AF. Treatment of central serous chorioretinopathy with the beta receptor blocker metoprolol. Klin Monatsbl Augenheilkd. 1993:199–205.

    Google Scholar 

  81. Lotery A, Sivaprasad S, O'Connell A, et al. Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4 months (VICI): a randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10220):294–303.

    Article  CAS  PubMed  Google Scholar 

  82. Ficker L, Vafidis G, While A, Leaver P. Long-term follow-up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy. Br j Ophthalmol. 1988;72:829–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Ambiya V, Khodani M, Goud A, et al. Early focal laser photocoagulation in acute central serous chorioretinopathy: a prospective, randomized study. Ophthalmic Surg Lasers Imaging Retina. 2017;48(7):564–71.

    Article  PubMed  Google Scholar 

  84. Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol. 1979;63:674–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Brancato R, Scialdone A, Pece A, Coscas G, Binaghi M. Eight-year follow-up of central serous chorioretinopathy with and without laser treatment. Graefes Arch Clin Exp Ophthalmol. 1987;225:166–8.

    Article  CAS  PubMed  Google Scholar 

  86. Yap EY, Robertson DM. The long-term outcome of central serous chorioretinopathy. Arch Ophthalmol. 1996;114:689–92.

    Article  CAS  PubMed  Google Scholar 

  87. Burumcek E, Mudum A, Karacorlu S, Arslan MO. Laser photocoagulation for persistent central serous chorioretinopathy: results of long-term follow-up. Ophthalmology. 1997;104:616–22.

    Article  CAS  PubMed  Google Scholar 

  88. Yannuzzi LA, Slakter JS, Kaufman SR, Gupta K. Laser treatment of diffuse retinal pigment epitheliopathy. Eur J Ophthalmol. 1992;2:103–14.

    Article  CAS  PubMed  Google Scholar 

  89. Sahu DK, Namperumalsamy P, Hilton G, et al. Bullous variant of idiopathic central serous chorioretinopathy. Br J Ophthalmol. 2000;84:485–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Battaglia Parodi M, Da Pozzo S, Ravalico G. Photodynamic therapy in chronic central serous chorioretinopathy. Retina. 2003;23:235–7.

    Article  CAS  PubMed  Google Scholar 

  91. Yannuzzi LA, Slakter JS, Gross NE, et al. Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina. 2003;23:288–98.

    Article  PubMed  Google Scholar 

  92. Ober M, Angelilli A, Do D, et al. Photodynamic therapy for acute central serous chorioretinopathy. Ophthalmology. 2005;112(12):2088–94.

    Article  PubMed  Google Scholar 

  93. Chan WM, Lai TY, Lai RY, et al. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial. Ophthalmology. 2008;115(10):1756–65.

    Article  PubMed  Google Scholar 

  94. Lim JI, Glassman AR, Aiello LP, et al. Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology. 2014;121(5):1073–8.

    Article  PubMed  Google Scholar 

  95. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010;117(9):1792–9.

    Article  PubMed  Google Scholar 

  96. Lanzetta P, Furlan F, Morgante L, et al. Nonvisible subthreshold micropulse diode laser (810 nm) treatment of central serous chorioretinopathy. A pilot study. Eur J Ophthalmol. 2008;18(6):934–40.

    Article  CAS  PubMed  Google Scholar 

  97. Roca JA, Wu L, Fromow-Guerra J, et al. Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group. Br J Ophthalmol. 2018;102(12):1696–700.

    Article  PubMed  Google Scholar 

  98. Scholz P, Altay L, Fauser S. Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy. Eye (Lond). 2016;30(10):1371–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  99. van Dijk EHC, Fauser S, Breukink MB, et al. Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE Trial. Ophthalmology. 2018;125(10):1547–55.

    Article  PubMed  Google Scholar 

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Spaide, R.F., Meyerle, C.B. (2020). CSCR (Central Serous Chorioretinopathy). In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_109-1

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