From the Guidelines
The incidence rate of central serous chorioretinopathy (CSC) is approximately 34.0 per 100,000 person-years in the general population, with a significantly higher incidence in men (54.2 per 100,000 person-years) compared to women (15.7 per 100,000 person-years) 1. This condition is characterized by fluid accumulation under the retina, leading to visual disturbances including blurred vision, distorted vision, and reduced color perception.
Key Points
- The incidence of CSC varies by gender, with men being nearly 3.5-fold more likely to develop the condition than women 1.
- The condition typically affects individuals between 30 and 50 years of age.
- Risk factors for CSC include stress, corticosteroid use, type A personality traits, and elevated cortisol levels.
- Most cases of CSC resolve spontaneously within 3-6 months without treatment, though some patients may require interventions such as photodynamic therapy, anti-VEGF injections, or mineralocorticoid receptor antagonists like eplerenone or spironolactone if the condition persists.
- Recurrence rates are significant, with approximately 30-50% of patients experiencing at least one recurrence within the first year after initial resolution.
Diagnosis and Treatment
- Multimodal imaging modalities, including OCT, FA, ICGA, and FAF, are important for establishing a diagnosis of CSC, as many other conditions can mimic CSC 1.
- The presence of SRF, as well as increased choroidal thickness, serous PEDs, and dilated choroidal veins, can be evaluated using OCT.
- Recent studies have shown the superiority of half-dose photodynamic therapy (PDT) over high-density subthreshold micropulse laser treatment and non-superiority of the oral mineralocorticoid receptor (MR) antagonist eplerenone treatment compared to placebo 1.
From the Research
Incidence Rate of Central Serous Chorioretinopathy
- The incidence rate of central serous chorioretinopathy (CSCR) is estimated to be around 10 per 100,000 in men, with CSCR occurring six times more commonly in men compared to women 2.
- The disease predominantly affects men between 30 and 50 years of age 3, 4.
- CSCR is characterized by retinal serous detachment, usually localized in the macular region, and can be acute or chronic 3, 4, 5.
Epidemiology and Risk Factors
- The annual incidence rate of CSCR is reported to be 10 per 100,000 in men 2.
- Risk factors for CSCR include systemic corticosteroid use, type A personality, pregnancy, and endogenous Cushing's syndrome 2.
- The disease can be precipitated by psychosocial stress and hypercortisolism 4.
Natural Course and Treatment
- Most acute CSCR cases resolve spontaneously within 2-3 months 2.
- The natural course of the disease is usually self-limiting, with spontaneous resolution and total fluid reabsorption 5.
- Treatment options include observation, conventional laser treatment, subthreshold laser treatment, photodynamic therapy, and treatment with mineralocorticoid receptor antagonists and anti-vascular endothelial growth factor drugs 6.