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Pharmaceuticals
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Pharmacotherapy of Central Serous Chorioretinopathy
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Pharmacotherapy of Central Serous Chorioretinopathy

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 17325

Special Issue Editor

Dr. Pierluigi Iacono

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Guest Editor
IRCCS Fondazione G.B. Bietti, Rome, Italy
Interests: myopia; central serous chorioretinopathy; choridal neovascularization; retinal disorders

Special Issue Information

Dear Colleagues,

Central serous chorioretinopathy (CSC) is one of the most common retinal disorders that ophthalmologists have to deal with. It may represent a real challenge due to a complex pathogenesis, as well as for the wide spectrum of clinical presentation through which it may begin. In addition, classification and its therapeutic approach are intriguing aspects.

This Special Issue aims to offer an update on the new CSC classification; a thorough description of the retinal morphological features that can be obtained with the most recent imaging methods; and finally and maybe above all, a critical review on the most common therapeutic options, namely photodynamic therapy with verteporfin, sub-threshold laser treatment and therapy with diuretics. We will be glad to receive a contribution from anyone wishing to bring personal experiences on all topics covered in this Special Issue.

Dr. Pierluigi Iacono
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceuticals is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Related Special Issue

Published Papers (5 papers)

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Research

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9 pages, 499 KiB  
Article
Central Serous Chorioretinopathy Classification
by Manuel Vilela and Carolina Mengue
Pharmaceuticals 2021, 14(1), 26; https://doi.org/10.3390/ph14010026 - 30 Dec 2020
Cited by 5 | Viewed by 2475
Abstract
Central serous chorioretinopathy is characterized by an idiopathic neurosensory detachment of the retina. This narrative review aims to discuss the classification system used for central serous chorioretinopathy. Based on our current knowledge, there is no universally adopted classification system. This is the result [...] Read more.
Central serous chorioretinopathy is characterized by an idiopathic neurosensory detachment of the retina. This narrative review aims to discuss the classification system used for central serous chorioretinopathy. Based on our current knowledge, there is no universally adopted classification system. This is the result of the unknown aspects related to pathogenesis and clinical spectrum and evolution. The best option could be to aggregate multimodal pieces of information alongside temporal and phenotypic characteristics. Full article
(This article belongs to the Special Issue Pharmacotherapy of Central Serous Chorioretinopathy)
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11 pages, 5684 KiB  
Article
Oral Eplerenone Versus Observation in the Management of Acute Central Serous Chorioretinopathy: A Prospective, Randomized Comparative Study
by Ramesh Venkatesh, Arpitha Pereira, Chaitra Jayadev, Vishma Prabhu, Aditya Aseem, Kushagra Jain, Bharathi Bavaharan, Naresh Kumar Yadav and Jay Chhablani
Pharmaceuticals 2020, 13(8), 170; https://doi.org/10.3390/ph13080170 - 29 Jul 2020
Cited by 8 | Viewed by 3208
Abstract
In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and [...] Read more.
In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for <12 weeks duration with no clinical or imaging features of chronicity. Patients were alternately divided into treatment (Table Eplerenone 50 mg/day for minimum 1 month) and observation groups. Vision, SRF height and subfoveal choroidal thickness (SFCT) were checked at 1-, 2- and 3-months in both eyes of each group. Each group had 29 eyes. Mean age was 40.4 ± 7.1 and 43.3 ± 8.34 years in treatment and observation group, respectively. Mean symptom duration was 6.46 ± 1.45 and 5.87 ± 2.09 weeks, respectively. Vision improvement to 6/6 was seen in 92%, 100% and 100% cases in treatment group and 74%, 86% and 100% in control group at each visit, respectively. Complete SRF resolution in the treatment group was noted in 45%, 55% and 62% cases at each respective monthly visit. In the observation group, complete SRF resolution was noted in 10%, 21% and 31% at 1-, 2- and 3-month visits, respectively. SRF (p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye. Full article
(This article belongs to the Special Issue Pharmacotherapy of Central Serous Chorioretinopathy)
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Review

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15 pages, 4549 KiB  
Review
Central Serous Chorioretinopathy: Treatment with Laser
by Maurizio Battaglia Parodi, Alessandro Arrigo, Pierluigi Iacono, Bruno Falcomatà and Francesco Bandello
Pharmaceuticals 2020, 13(11), 359; https://doi.org/10.3390/ph13110359 - 2 Nov 2020
Cited by 15 | Viewed by 4122
Abstract
Currently, no general consensus exists regarding the management of central serous chorioretinopathy (CSC). Laser treatments include three different therapeutic approaches: conventional laser, subthreshold laser and photodynamic therapy. Conventional focal laser, addressed to seal the leaking points, as evidenced on fluorescein angiography, was largely [...] Read more.
Currently, no general consensus exists regarding the management of central serous chorioretinopathy (CSC). Laser treatments include three different therapeutic approaches: conventional laser, subthreshold laser and photodynamic therapy. Conventional focal laser, addressed to seal the leaking points, as evidenced on fluorescein angiography, was largely used in the past, but now, it is almost completely abandoned, owing to the potential complications. Several studies confirmed the positive effects achieved by subthreshold laser treatment in CSC, even though its improper application in the PLACE trial has questioned the effectiveness. Full article
(This article belongs to the Special Issue Pharmacotherapy of Central Serous Chorioretinopathy)
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18 pages, 1537 KiB  
Review
Photodynamic Therapy with Verteporfin for Chronic Central Serous Chorioretinopathy: A Review of Data and Efficacy
by Pierluigi Iacono, Stefano Da Pozzo, Monica Varano and Mariacristina Parravano
Pharmaceuticals 2020, 13(11), 349; https://doi.org/10.3390/ph13110349 - 29 Oct 2020
Cited by 17 | Viewed by 3093
Abstract
Central serous chorioretinopathy represents the fourth most frequent retinal disorder, occurring especially in young age. Central serous chorioretinopathy is mainly characterized by macular serous retinal detachment and although the clinical course moves frequently toward a spontaneous resolution, the subretinal fluid may persist for [...] Read more.
Central serous chorioretinopathy represents the fourth most frequent retinal disorder, occurring especially in young age. Central serous chorioretinopathy is mainly characterized by macular serous retinal detachment and although the clinical course moves frequently toward a spontaneous resolution, the subretinal fluid may persist for a long time, thus evolving to the chronic form, and leading to a potential damage of the retinal pigment epithelium and to photoreceptors. The photodynamic therapy with verteporfin plays an important role in the armamentarium among the many therapeutic options employed in this complex retinal disorder. In this review, the authors aim to summarize data of efficacy and safety of PDT focusing especially on mechanisms of action of the PDT and providing comparative outcomes with the alternative therapeutic approaches, including especially the subthreshold laser treatment. Full article
(This article belongs to the Special Issue Pharmacotherapy of Central Serous Chorioretinopathy)
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13 pages, 7421 KiB  
Review
Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review
by Francesco Sartini, Martina Menchini, Chiara Posarelli, Giamberto Casini and Michele Figus
Pharmaceuticals 2020, 13(9), 221; https://doi.org/10.3390/ph13090221 - 28 Aug 2020
Cited by 16 | Viewed by 3908
Abstract
Bullous central serous chorioretinopathy (bCSCR) is a rare variant of the central serous chorioretinopathy, complicated by an exudative retinal detachment with shifting fluid. This systematic review aims to present the epidemiology, the pathogenesis, the clinical presentation, the imaging, the differential diagnosis, and the [...] Read more.
Bullous central serous chorioretinopathy (bCSCR) is a rare variant of the central serous chorioretinopathy, complicated by an exudative retinal detachment with shifting fluid. This systematic review aims to present the epidemiology, the pathogenesis, the clinical presentation, the imaging, the differential diagnosis, and the latest treatments of this disease. A total of 60 studies were identified following a literature search adhering to PRISMA guidelines. After full-text evaluation, 34 studies about bCSCR were included. bCSCR usually affects middle-aged men, and the principal risk factor is corticosteroid medications. Pathogenesis is related to an increased choroidal vessel and choriocapillaris permeability, with subsequent subretinal fluid accumulation, rich in fibrin, which may provoke the exudative retinal detachment. Clinical presentation and imaging are fundamental to distinguish bCSCR from other pathologies, avoiding unappropriated treatment. Corticosteroid withdraws (if assumed) and laser photocoagulation of leakage sites seen at angiography may speed up retinal reattachment. Verteporfin photodynamic therapy, transpupillary thermal therapy, oral eplerenone and scleral thinning surgery are other therapeutic options. An early diagnosis might prevent disease progression due to harmful medications as well as unnecessary surgery. Full article
(This article belongs to the Special Issue Pharmacotherapy of Central Serous Chorioretinopathy)
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