Abstract
Central serous chorioretinopathy is one of the most frequent causes of vision reduction among middle-aged men. This disease usually has a self-limiting course, but sometimes it lasts more than 4–6 months or a second episode follows a complete resolution of the first one. Nevertheless, to date no consensus exists about the duration threshold and therapy protocols for these non-resolving central serous chorioretinopathy. Treatment as half-dose and half-fluence photodynamic therapy, subthreshold micropulse laser treatment, mineralocorticoid receptor antagonists, intravitreal anti-angiogenic drugs, transpupillary thermal therapy, anti-androgenic drugs, methotrexate, Rifampicin and melatonin are described in this review. Complications are very uncommon but end-point results like central macular thickness reduction and best-corrected visual acuity improvement are difficult to compare among different therapeutic modalities due to different duration of follow-up and lack of homogeneity in patient recruitment. The aim of this review is focusing on treatment modalities for these chronic forms with comprehensive recent management updates according to latest clinical trial results.
摘要
中心性浆液性脉络膜视网膜病变是导致中年男性视力下降最常见的原因之一。这种疾病通常具有自限性, 但有时它会持续4-6个月以上, 或在第一次治愈后复发。然而, 迄今为止, 人们对于这种难治性中心性浆液性脉络膜视网膜病变的时间阈值和治疗方案尚未达成共识。本文综述了半剂量、半效应光动力疗法、阈下微脉冲激光光凝治疗、盐皮质激素受体阻断剂、玻璃体内注入抗新生血管药物、经瞳孔温热疗法、抗雄激素药物、甲氨蝶呤、利福平、褪黑激素等治疗方法的疗效。以上几种治疗方法的并发症少见, 但由于随访时间不同和招募的患者缺乏同质性, 导致难以比较不同治疗方法下患者的黄斑中心凹厚度的减少和最佳矫正视力的提高等疗效。本综述的目的是根据最新的临床试验结果, 对这种慢性疾病的治疗方案的管理进行全面的更新。
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Sartini, F., Figus, M., Nardi, M. et al. Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options. Eye 33, 1035–1043 (2019). https://doi.org/10.1038/s41433-019-0381-7
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DOI: https://doi.org/10.1038/s41433-019-0381-7
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