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| EDITORIAL |
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| Year : 2022 | Volume
: 12
| Issue : 4 | Page : 379-380 |
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Update on the pathophysiology and treatment of central serous chorioretinopathy
Seung-Young Yu
Department of Ophthalmology, Kyung Hee University Hospital, Seoul, Korea
| Date of Submission | 10-Nov-2022 |
| Date of Acceptance | 10-Nov-2022 |
| Date of Web Publication | 05-Dec-2022 |
Correspondence Address:
Prof. Seung-Young Yu
Department of Ophthalmology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447
Korea
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2211-5056.362603
How to cite this article:
Yu SY. Update on the pathophysiology and treatment of central serous chorioretinopathy. Taiwan J Ophthalmol 2022;12:379-80 |
It is an honor to take the role of editor for a special edition of the Taiwan Journal of Ophthalmology. The special edition theme is central serous chorioretinopathy (CSC). An effort was made to cover the definition, pathophysiology, diagnosis, and even recent treatment trends of CSC. The history of CSC disease is long. CSC was first described by Albrecht von Graefe in 1866 as a disease causing recurrent serous retinal detachment, which was described as central recurrent retinitis. One hundred years later, Bennett proposed the term central serous retinopathy, and after that Gass named it idiopathic central serous choroidopathy in 1967, this is now called CSC.
The recent development of imaging technology by enhanced depth imaging optical coherence tomography, optical coherence tomography angiography, and indocyanine green angiography has broadened the understanding of the pathophysiology of CSC. It is characterized by local or general thickening of the choroid, thinning of the choriocapillaris, and hyperpermeability of dilated choroidal vessels. It is understood to cause serous detachment of the neurosensory retina and/or retinal pigment epithelium detachment at the posterior pole by the damaged barrier function of the retinal pigment epithelium caused by hyperpermeability of the choroidal blood vessels. Recently, this disease has been considered one of the types caused by a mechanism called pachychoroid spectrum disease. In addition, recent evidence of choroidal dysfunction has provided clues to understanding the pathogenesis of CSC. Spaide et al.[1],[2] proposed a new hypothesis of intervortex venous anastomosis and choroidal venous overload as the pathophysiology of CSC in 2021 and 2022.
CSC treatment is still controversial, but according to evidence from clinical trials, photodynamic therapy appears to be the most effective treatment. Because steroids are a strong risk factor for CSC, it is important to confirm whether or not steroids are being used in patients with CSC. Conventional laser photocoagulation, micropulse diode laser photocoagulation, anti‒vascular endothelial growth factor therapy, and mineralocorticoid receptor antagonist therapy have been studied as other treatment options for patients with CSC, but more strong evidence is needed.
Although there have been advances in CSC diagnosis and treatment, there is still a lack of understanding of acute and chronic CSC differentiation and progression to type 1 macular neovascularization (MNV), polypoidal choroidal vasculopathy (PCV), and late atrophic stages. We hope that this special edition of the Taiwan Journal of Ophthalmology will serve as an opportunity to broaden your understanding of CSC as well as perspective on disease and treatment.
| References | |  |
| 1. | Spaide RF, Ledesma-Gil G, Gemmy Cheung CM. INTERVORTEX VENOUS ANASTOMOSIS IN Pachychoroid-RELATED DISORDERS. Retina. 2021;41:997-1004.  |
| 2. | Spaide RF, Gemmy Cheung CM, Matsumoto H, Kishi S, Boon CJF, van Dijk EHC, et al. Venous overload choroidopathy: A hypothetical framework for central serous chorioretinopathy and allied disorders. Prog Retin Eye Res 2022;86:100973. |
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