Central Serous Chorioretinopathy Management and Diagnostic Techniques

Central serous chorioretinopathy (CSC) is an idiopathic retinal disorder characterised by serous detachment of the neurosensory retina at the macula, often arising in the context of a thickened choroid and focal leakage from the retinal pigment epithelium. Clinically it manifests with blurred or distorted central vision, micropsia and metamorphopsia. Diagnostic evaluation hinges on multimodal imaging: spectral-domain optical coherence tomography (OCT) delineates subretinal fluid and retinal pigment epithelium irregularities; fluorescein and indocyanine green angiography (FA/ICGA) localise leakage points and assess choroidal circulation; OCT angiography (OCT-A) reveals choriocapillaris flow disturbances without dye injection. Biomarkers in ocular fluids and artificial-intelligence-assisted analysis of OCT images are evolving as adjuncts to conventional imaging. Management strategies stratify acute versus chronic presentations. Observation remains the first-line in many acute cases, given the high rate of spontaneous resolution. Chronic or recurrent disease often benefits from half-dose photodynamic therapy to induce choroidal vascular remodelling, while focal or micropulse laser may be applied to leaking sites. Oral mineralocorticoid receptor antagonists have shown moderate benefit in reducing choroidal thickness, and anti-vascular endothelial growth factor agents are reserved for complications such as secondary neovascularisation. Emerging approaches include targeted molecular therapies that modulate choroidal endothelial function and neuromodulation of choroidal neurons to address underlying pachychoroid physiology.

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Central Serous Chorioretinopathy Management and Diagnostic Techniques publication trend

The graph below shows the total number of articles in central serous chorioretinopathy management and diagnostic techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Central serous chorioretinopathy (CSC): A retinal disorder involving serous detachment of the neurosensory retina due to choroidal hyperpermeability.

Photodynamic therapy (PDT): A treatment combining a photosensitising agent and low-energy laser to induce targeted vascular remodelling.

Optical coherence tomography (OCT): A non-invasive imaging modality that provides high-resolution cross-sectional views of retinal and choroidal structures.

Pachychoroid: A spectrum of disorders characterised by abnormally thickened choroid and dilated outer choroidal vessels.

Exosome: A small extracellular vesicle that carries proteins and RNA, used here to detect disease-specific microRNAs in ocular fluid.

Mineralocorticoid receptor antagonist: A systemic agent that inhibits choroidal vascular responses to corticosteroids and may reduce choroidal thickness.

References

1. Exosomal miR-184 in the aqueous humor of patients with central serous chorioretinopathy: a potential diagnostic and prognostic biomarker. Journal of Nanobiotechnology (2023).
2. Developing and Evaluating an AI-Based Computer-Aided Diagnosis System for Retinal Disease: Diagnostic Study for Central Serous Chorioretinopathy. Journal of Medical Internet Research (2023).
3. Central serous chorioretinopathy: Towards an evidence-based treatment guideline. Progress in Retinal and Eye Research (2019).
4. The choroidal nervous system: a link between mineralocorticoid receptor and pachychoroid. Acta Neuropathologica (2023).
5. OCT Angiography Compared to Fluorescein and Indocyanine Green Angiography in Chronic Central Serous ChorioretinopathyAngio-OCT, FA, and ICGA in Chronic CSC. Investigative Ophthalmology & Visual Science (2015).