Parodi, M. B., S. Da Pozzo, et al. (2003). "Photodynamic Therapy in Chronic Central Serous Chorioretinopathy." Retina 23(2): 235-237.
Haimovici, R., S. Rumelt, et al. (2003). "Endocrine abnormalities in patients with central serous chorioretinopathy." Ophthalmology 110(4): 698-703.
PURPOSE: To investigate and to identify endocrine and metabolic abnormalities in patients with central serous chorioretinopathy (CSCR). DESIGN: Observational case series. PARTICIPANTS: Twenty-four patients with CSCR. METHODS: Serum and urinary catecholamines, glucocorticoids, mineralocorticoids, serum testosterone, and thyroid-stimulating hormone (TSH) function were evaluated prospectively. RESULTS: Fifty percent (12 of 24) of patients with active acute CSCR showed elevated 24-hour urine cortisol or tetrahydroaldosterone levels. Serum aldosterone levels were low in 7 of 24 (29.1%) patients. Single morning plasma catecholamine levels were elevated in 7 of 24 patients, although 24-hour urine metanephrines (catecholamine breakdown products) were normal. Serum testosterone and TSH levels were normal in nearly all (23 of 24) patients. CONCLUSION: Many patients with acute CSCR have elevated 24-hour urine corticosteroids, which may contribute to the pathogenesis of the disorder. Endogenous mineralocorticoid dysfunction is a newly described feature of CSCR.
Zhang, W. and K. Zhao (2003). "Multifocal electroretinography in central serous chorio-retinopathy and assessment of the reproducibility of the multifocal electroretinography." Doc Ophthalmol 106(2): 209-13.
PURPOSE: To measure and compare the difference of multifocal electroretinography (mERG) in control subjects and patients with central serous chorio-retinopathy (CSCR) and assessing the reproducibility of the multifocal electroretinography. METHODS: Sixteen cases of control subjects and 12 cases of central serous chorio-retinopathy were tested with the Visual Evoked Response Imaging System science4.2 made by EDI company of America. The results of the left eye of each control subject and patient were used for statistical evaluation by the Mann-Whitney U test. Repeat measurements were performed on 11 control subjects. Wilcoxon technique were used to quantify the reproducibility of the test. RESULTS: The P1 waveform average response density of 1-3 rings in central serous chorio-retinopathy were decreased statistically. There was no significant difference between repeat measurements on 11 individuals. CONCLUSION: Multifocal electroretinography can be used to quantify the visual function of the affected area in chorio-retinopathy and showed good agreement in the data distribution for the repeat measurements.
Katsimpris, J. M., M. Vandoros, et al. (2003). "Central serous chorioretinopathy associated with adrenal myelolipoma." Klin Monatsbl Augenheilkd 220(3): 199-203.
BACKGROUND: We describe a case of central serous chorioretinopathy associated with a large adrenal myelolipoma. HISTORY AND SIGNS: A 55-year old man was admitted to our clinic complaining for metamorphopsia and blurred vision in his left eye. Standard ophthalmologic examination and fluorescein angiography established the diagnosis of central serous chorioretinopathy (CSC). Due to the presence of arterial hypertension, we proceeded to a thorough systemic clinical and laboratory investigation. THERAPY AND OUTCOME: Clinical and laboratory investigation disclosed a large mass in the right abdominal region. Magnetic resonance imaging showed that this mass was located superior to the right kidney, in the right adrenal gland, compressing the kidney and the liver. Surgical excision of the mass was done one month later. Histological examination revealed an adrenal myelolipoma. Improvement of CSC was recorded one month after surgery with complete remission two months later. Additionally, systemic blood pressure and increased urinary steroids concentration before the operation returned to normal in the late postoperative period. CONCLUSIONS: CSC pathogenesis is not well understood. Many factors are implicated in this disease. Hypercortisolism and sympathetic activity play a crucial role in the pathogenesis of CSC. This is the first report of CSC in a patient with a benign tumor of the adrenal gland without Cushing's syndrome.
Costa, R., L. Scapucin, et al. (2002). "Indocyanine green-mediated photothrombosis as a new technique of treatment for persistent central serous chorioretinopathy." Curr Eye Res 25(5): 287-97.
Purpose. To evaluate the potential benefit and complications of indocyanine green-mediated photothrombosis (IMP) in the management of patients with persistent central serous chorioretinopathy (CSC). Methods. Interventional noncomparative case series. Eleven patients with CSC presenting with persistent subretinal fluid in optical coherence tomography (OCT) four months after presentation and decrease in visual acuity (VA) were submitted to a single IMP session with 2 mg/kg body weight ICG and application of 5.6 W/cm(2) light at 810 nm. A continuous follow-up was provided with best-corrected ETDRS VA assessment, and angiographic and OCT documentation 72 hours before and at 2 days, 1 and 2 weeks, 1, 3, 6, and 12 months after treatment. Results. Pretreatment VA levels ranged from 20/32 - 1 to 20/100 (mean, 20/63 + 2 [logMAR equivalent, 0.460 +/- 0.155]); post treatment levels ranged from 20/25 - 2 to 20/20 (mean, 20/20 - 2 [logMAR equivalent, 0.038 +/- 0.048]). Ten out of eleven patients presented with VA levels of >/=20/25 2 weeks after treatment; the mean logMAR VA change of 0.345 at that time was statistically significant (p < 0.05, Friedman test). OCT disclosed resolution of persistent subretinal fluid in all eyes. No recurrence was observed after 12 months of follow-up. Complications included transient retinal whitening in two patients, and associated occlusion of retinal capillaries in one. Conclusions. Photothrombosis using low-intensity 810 nm light to direct laser energy continuously at the active leakage sites after intravenous ICG infusion induced rapid VA recovery in patients with persistent CSC; accordingly, restoration of the macular architecture was evidenced on OCT, and no recurrence was noted 12 months after IMP.
Iida, T., L. A. Yannuzzi, et al. (2003). "Cystoid macular degeneration in chronic central serous chorioretinopathy." Retina 23(1): 1-7; quiz 137-8.
PURPOSE: To describe the optical coherence tomography (OCT) and fluorescein angiography findings in the macula of eyes with chronic central serous chorioretinopathy (CSC) and reduced central vision. METHODS: Using OCT, clinical examination, and fluorescein and indocyanine green (ICG) angiography, the authors examined eight eyes of seven patients with CSC, an attached macula, and reduced central vision of 20/200 or worse. All had a history of chronic CSC with resolution of the subretinal fluid in the macular area and poor vision. RESULTS: Patient ages ranged from 55 to 82 years (mean, 66 years). All eight eyes had some parafoveal, patchy RPE atrophy with corresponding transmission hyperfluorescence (window defect) on fluorescein angiography. Five eyes also had a window defect in the foveal area. With OCT, the foveal area revealed variable areas of cystoid change and atrophy in seven of the eight eyes. In four of these eyes, the cystoid changes were not seen on clinical examination or fluorescein angiography. The seven eyes with cystoid changes imaged with OCT had no intraretinal leakage of fluorescein in the foveal region. The authors categorized these eyes as having cystoid macular degeneration (CMD). One other eye had foveal thinning or atrophy without cystoid changes. CONCLUSIONS: Intraretinal cystoid spaces without intraretinal leakage, or CMD, was a common finding in eyes with chronic CSC and reduced central vision after resolution of subretinal fluid. OCT was useful to establish the presence of CMD and foveal atrophy, even when these changes were not clearly evident on clinical examination or fluorescein angiography. Chronic foveal detachment and antecedent intraretinal leakage were proposed to be the mechanisms for the development of the changes. CMD in conjunction with foveal atrophy was an important clinical finding to account for the poor visual outcome in patients with CSC.
Chrapek, O., K. Spackova, et al. (2002). "[Treatment of central serous chorioretinopathy with beta blockers]." Cesk Slov Oftalmol 58(6): 382-6.
On a group of 13 eyes the authors evaluate their experience with medicamentous treatment of central serous chorioretinopathy. For treatment they used the non-selective beta-blocker Trimepranol, 2 x 5 mg/day. They found that in 11 eyes, in 84.6% cases, adherence of the ablated neuroepithelium of the macula occurred latest within four months of treatment, in two eyes (15.4%) this therapeutic dose did not lead to remission of the disease even after four months of treatment and the condition was evaluated as failure of treatment. The authors conclude that a therapeutic dose of Trimepranol of 2 x 5 mg/day is not a reliable therapeutic solution of central serous chorioretinopathy.
Todd, K. C., D. P. Hainsworth, et al. (2002). "Longitudinal analysis of central serous chorioretinopathy and sex." Can J Ophthalmol 37(7): 405-8.
BACKGROUND: Stress has been proposed as one of the contributing factors of central serous chorioretinopathy (CSC). Because the number of women in the workforce has increased dramatically in past decades, their presumed additional stress may increase their risk for CSC. We performed a study to determine whether the ratio of men to women in whom CSC was diagnosed remained constant between 1970 and 2000 in our patient population. METHODS: We reviewed the medical records of 88 patients (69 males and 19 females) in whom CSC was diagnosed between 1970 and 2000. Only patients who were noted to have subretinal fluid on stereoscopic colour fundus photographs and focal retinal pigment epithelial hyperfluorescence on fluorescein angiography were included. Logistic regression analysis was performed to determine the probability of a patient's being male over the study period. RESULTS: No significant change was found in the proportion of male patients in whom CSC was diagnosed over the study period (p = 0.69). INTERPRETATION: The ratio of males to females with a diagnosis of CSC did not change significantly over 30 years in our study population. If stress is a contributing factor of CSC and if women are experiencing increased stress from changing societal roles, women may have different adaptations to stress than men, or other mechanisms of CSC formation may be present.
Yi, C., H. Yan, et al. (1999). "[Analyses of central serous chorioretinopathy from indocyanine green angiography]." Yan Ke Xue Bao 15(2): 81-4.
PURPOSE: To compare and analyse the characters of Indocyanine Green Angiography (ICGA) and Fundus Fluorescein Angiography (FFA) in Central Serous Chorioretinopathy (CSCR) and explore its pathological significance. METHOD: 35 cases of CSCR were examed with Heidelberg Retina Angiography. Simultaneous images of ICGA and FFA were analysed. RESULTS: Among the 35 cases, 29(83%) revealed more lesions in ICGA than in FFA. The lesions appeared in FFA were all associated with ICGA changes. CONCLUSION: The increasing of choroid hyperpermeability is an early change, which causes the overlying RPE dysfunction and structural damage. Some points related to the laser and medical treatment to CSCR were also discussed.
Gismero Moreno, S., M. J. Morillo Sanchez, et al. (2003). "[Retinal pigment epithelial atrophic tracks secondary to central serous pigment epitheliopathy]." Arch Soc Esp Oftalmol 78(1): 35-8.
PURPOSE AND METHODS: We report the cases of three patients with retinal pigment epithelial atrophic tracks secondary to central serous pigment epitheliopathy specially focusing on fluorescein angiographic findings. This entity is considered an atipical manifestation of central serous chorioretinopathy called chronic diffuse retinal pigment epitheliopathy. RESULTS AND CONCLUSIONS: We have studied 69 patients with the diagnose of central serous pigment epiteliopathy in our unit; 10.14% manifested diffuse retinal pigment epitheliopathy and 5.79% showed retinal pigment epithelial atrophic tracks. Both eyes were involved in 100% and all of them were males with a median age of 53.33 years. We can conclude that this entity usually affects adult males and it is frequently bilateral (Arch Soc Esp Oftalmol 2003; 78: 35-38).
Ha, T. W., D. I. Ham, et al. (2002). "Management of choroidal neovascularization following laser photocoagulation for central serous chorioretinopathy." Korean J Ophthalmol 16(2): 88-92.
Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Mauget-Faysse, M., L. Kodjikian, et al. (2002). "[Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy. Results of the first prospective pilot study]." J Fr Ophtalmol 25(10): 1021-5.
PURPOSE: Helicobacter pylori has been implicated in focal occlusive arterial diseases in young people. Central serous chorioretinopathy (CSC) and diffuse retinal epitheliopathy (DRE) being suspected vascular occlusive diseases of choriocapillaris, the purpose of this study was to determine the prevalence of H. pylori infection in patients with long-lasting (>6 months) CSC and/or DRE. METHODS: Sixteen consecutive patients living in southeastern France were included in this prospective pilot study. H. pylori infection was assessed by the (13)C-urea breath test, serology, as well as histology of gastric biopsy specimens in some cases. RESULTS: Evidence for H. pylori infection was detected in nine out of the 16 patients with active long-lasting CSC/DRE (56.3%). H. pylori-infected patients more frequently presented gastric pain (four of nine H. pylori-positive patients: 44%) than H. pylori-negative patients (one out of seven: 14%). Men were more frequently H. pylori-positive (seven men out of ten: 70%) than women (two women out of a total of six: 33%). DISCUSSION: When the prevalence of H. pylori infection (56.3%) was compared to the prevalence in a historical control population from southeastern France (27.5%), it was found to be significantly higher (P<0.05). CONCLUSION: These results may indicate a possible association between H. pylori infection and CSC/DRE manifestations. This new etiopathogenic hypothesis deserves to be confirmed in a national or international multicenter study because it could lead to a new therapeutic approach in CSC/DRE, i.e., Helicobacter pylori eradication.
Ikeda, T., K. Sato, et al. (2003). "Central serous chorioretinopathy exhibiting a vitelliform lesion similar to best disease." Arch Ophthalmol 121(1): 146-7.
Lee, Y. C. and S. J. Sheu (2002). "Choroidal osteoma masquerading as central serous chorioretinopathy." Kaohsiung J Med Sci 18(8): 408-11.
We report a rare case of choroidal osteoma masquerading as central serous chorioretinopathy. A 39-year-old man complained of intermittent episodes of blurred vision in the left eye for 2 months. Fundus examination of the left eye showed a dome-shaped elevation at the macular center. Fluorescein angiography showed a patch of pinpoint leakage resulting in a well-defined pool of dye at the macular center. Initial diagnosis was recurrent central serous chorioretinopathy with sequelae in the left eye. Five months later, serous detachment recurred. Computerized tomography and ultrasonography showed a bony plaque at the choroid level, and choroidal osteoma was diagnosed.
Karashima, K., S. Fujioka, et al. (2002). "Two cases of central serous chorioretinopathy treated with photocoagulation after bone marrow transplantation." Retina 22(5): 651-3.
Newman, D. G. (2002). "Central serous retinopathy with permanent visual deficit in a commercial air transport pilot: a case report." Aviat Space Environ Med 73(11): 1122-6.
This report describes a case of central serous retinopathy (CSR) in the right eye of a commercial air transport pilot which resulted in a permanent reduction in visual acuity and the loss of his license. The previously fit and well pilot developed sudden loss of central vision, which resolved spontaneously. He then went on to experience recurrent episodes of fluctuating visual acuity (down to 6/60) and visual dysfunction in the right eye. His left eye remained unaffected. Eventually his condition stabilized, and he was left with a permanent reduction in right visual acuity (6/36) with intact peripheral visual fields and a completely normal left eye. After a period of grounding of 12 mo, he sought to have his license reinstated. He was considered to be a functionally monocular pilot, and as such was granted a conditional Class 1 medical category. The aeromedical disposition of this pilot and the issues involved in determining the fitness to fly of pilots with permanent visual defects arising from CSR are discussed.
Bouzas, E. A., P. Karadimas, et al. (2002). "Central serous chorioretinopathy and glucocorticoids." Surv Ophthalmol 47(5): 431-48.
Central serous chorioretinopathy is a relatively common retinal disease characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. It typically affects young and middle-aged men with no previous medical and family history, and no systemic symptoms or signs. However, it has been noted that central serous chorioretinopathy is associated with different conditions, characterized by exposure to increased levels of endogenous or exogenous glucocorticoids. In fact, central serous chorioretinopathy has been described in patients with endogenous Cushing's syndrome. It is also prevalent in patients with type-A behavior, and following stressful events, and pregnancy probably represents a risk factor for central serous chorioretinopathy; these conditions are characterized by endogenous hypercortisolism. In addition, many cases of central serous chorioretinopathy have been described during or following treatment with glucocorticoids, administrated by any route, for various systemic or ocular conditions. Central serous chorioretinopathy, when related to the exposure to exogenous glucocorticoids, has a less prominent male predilection, presents more often with a chronic or atypical form, and is frequently bilateral. Furthermore, treatment of central serous chorioretinopathy with glucocorticoids was found to exacerbate the clinical picture. Based on these observations it could be suggested that glucocorticoids may be involved in the development of central serous chorioretinopathy, even though the exact pathogenic mechanism remains unclear. Glucocorticoids should not be used in the treatment of central serous chorioretinopathy and central serous chorioretinopathy should be added to the list of ocular complications of glucocorticoids.
Ochiai, J., M. Kato, et al. (2002). "[The changes over time in areas of abnormal choroidal staining in central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 106(9): 583-9.
PURPOSE: We discuss the permeability of the choroid in central serous chorioretinopathy (CSC). METHODS: Forty-eight eyes of 48 patients with active CSC and their fellow eyes were studied with indocyanine green angiography (IA). Abnormal choroidal stainings in the late phase were fed in to a computer and hyperfluorescent areas were summated. The hyperfluorescent area at the initial examination was compared with that at the second examination. The values obtained were compared with the clinical characteristics shown by ophthalmoscopic, fluorescein angiographic (FA), and IA findings. RESULTS: The abnormal choroidal staining during IA was observed in 90% of the affected eyes and 67% of the fellow eyes. The average abnormal staining area was larger in the affected eyes than in the fellow eyes and decreased over time in both affected and fellow eyes, but the decrease rate of the abnormal staining was higher in the affected eyes. In FA abnormal staining areas of the smokestack type were significantly smaller than those of the round-diffusion type. The range of abnormal choroidal staining was significantly smaller in the affected eyes treated with laser photocoagulation than in the eyes not treated without laser coagulation. CONCLUSIONS: We conclude that the range of abnormal choroidal staining is consistent with changes of activity in the course of CSC, that the malfunction of the retinal pigment epithelium and choroidal hyperpermeability mutually influence CSC and that the disappearance of serous detachment in the clinical course plays an important role in the improvement of choroidal permeability and the retinal pigment epithelium function.
Carvalho-Recchia, C. A., L. A. Yannuzzi, et al. (2002). "Corticosteroids and central serous chorioretinopathy." Ophthalmology 109(10): 1834-7.
PURPOSE: The purpose of this study is to investigate the relationship between corticosteroid use and central serous chorioretinopathy (CSC). DESIGN: A prospective, case-controlled study. PARTICIPANTS AND CONTROLS: A consecutive series of patients with acute manifestations of CSC and a control group matched for age, race, and gender were recruited between January 2000 and July 2000. METHODS: A detailed clinical history was taken, and fundus examination with slit-lamp biomicroscopy was performed on all patients. Fluorescein angiography was obtained on the study patients. RESULTS: A total of 50 patients was recruited. Twenty-six patients (52%) had a history of exogenous steroid use, including oral, intravenous, intranasal, and intraarticular administration. Two additional patients had a history of endogenous hypercortisolism (Cushing's syndrome). In a matched control group, eight patients (18%) had a history of steroid use. The difference in corticosteroid exposure between study patients and controls was statistically significant (P < 0.0001). MAIN OUTCOME MEASURES: History of corticosteroid use or Cushing's syndrome. CONCLUSIONS: This study is consistent with previous reports associating steroid use with CSC. It identifies corticosteroids as a significant risk factor for the development of acute, exudative macular manifestation and implicates hypercortisolism as a factor in the pathogenesis of this disorder. Several forms of corticosteroid administration were observed to be a risk factor for CSC. Accordingly, susceptible patients in need of corticosteroids should be advised of the risk of developing acute manifestations of CSC.
Jampol, L. M., R. Weinreb, et al. (2002). "Involvement of corticosteroids and catecholamines in the pathogenesis of central serous chorioretinopathy: a rationale for new treatment strategies." Ophthalmology 109(10): 1765-6.
Pikkel, J., I. Beiran, et al. (2002). "Acetazolamide for central serous retinopathy." Ophthalmology 109(9): 1723-5.
OBJECTIVE: To find out whether acetazolamide has a beneficial effect in the treatment of central serous retinopathy (CSR). DESIGN: Prospective, nonrandomized, comparative trial. PARTICIPANTS: Fifteen acetazolamide-treated and 7 untreated (control) CSR patients who completed at least 24 months of follow-up. METHODS: Patients in the treatment group were given systemic acetazolamide according to a standard protocol. Main outcome measures were compared between treatment and control groups using Student's t test and the Mann-Whitney U test for statistical analysis. MAIN OUTCOME MEASURES: Time until subjective visual improvement, time until full clinical resolution, and rate of recurrences. RESULTS: Mean times to both subjective visual improvement and clinical resolution of the attack were shorter in the study group than in the control group. Recurrence rate did not differ between the study and control groups. CONCLUSIONS: Acetazolamide treatment for CSR shortens the time for subjective and objective clinical resolution, but has no effect on either final visual acuity or recurrence rate of the disease.
Fardin, B. and D. J. Weissgold (2002). "Central serous chorioretinopathy after inhaled steroid use for post-mycoplasmal bronchospasm." Br J Ophthalmol 86(9): 1065-6.
Kanyange, M. L. and J. J. De Laey (2002). "Long-term follow-up of central serous chorioretinopathy (CSCR)." Bull Soc Belge Ophtalmol(284): 39-44.
We studied retrospectively the clinical files of 6 patients (11 eyes), who were diagnosed as CSCR between 1968 and 1986. They were all males, aged from 28 tot 46. The initial diagnosis of CSCR was based on the clinical symptoms and ophthalmic findings. It was supported by fluorescein angiography and later also by ICG angiography. Eight eyes have been treated by laser. After a follow-up of at least 15 years: 2 of the treated eyes and one untreated eye developed subretinal neovascularization; 6 of the treated eyes and one untreated eye progressed to diffuse pigment epitheliopathy; Final visual acuity was less than 2/10 in 6 eyes.
Cheng, L. L., A. K. Kwok, et al. (2002). "Graft-vs-host-disease-associated conjunctival chemosis and central serous chorioretinopathy after bone marrow transplant." Am J Ophthalmol 134(2): 293-5.
PURPOSE: To describe bilateral conjunctival chemosis and central serous chorioretinopathy in a patient with graft-vs-host disease after bone marrow transplant. DESIGN: Interventional case report. METHODS: A 45-year-old Chinese woman developed blurring of vision 16 days after bone marrow transplant for multiple myeloma. She had graft-vs-host disease 11 days after bone marrow transplantation. On examination, vision was 0.6 in the right eye and 0.3 in the left eye. Bilateral conjunctival chemosis and multiple central serous chorioretinopathy were present. RESULTS: Treatment of graft-vs-host disease with high-dose systemic corticosteroid and cyclosporin led to the resolution of the conjunctival chemosis and central serous chorioretinopathy 3 months later. Visual acuity improved to 0.8 in both eyes. CONCLUSION: Choroidal infiltrate in graft-vs-host disease may contribute to choroidal hyperpermeability, which leads to the development of central serous chorioretinopathy in postbone marrow transplant patients.
Tatomirovic, Z., R. Bokun, et al. (2002). "Intrathecal synthesis of complement components C3c and C4 in the central nervous system infections with signs of the acute serous meningitis syndrome." Vojnosanit Pregl 59(3): 265-70.
Two hundred and ten patients with meningismus and the infections of the central nervous system (CNS) with the clinical symptoms and signs of the acute serous meningitis syndrome, were divided in to groups according to etiology (enterovirus meningitis-ENTERO, serous meningitis various etiology-SM and tuberculous meningitis-TBC). Intrathecal synthesis (ITS) of C3c and C4 complement components and IgG were determined by the method of cerebrospinal indexes (I), to examine their role in differential diagnosis of this syndrome. Correlative study between the CSF/serum ratio (Q) for albumin (Alb) and QC3c and QC4 in patients with no proven ITS of this two complement proteins, and the comparative study of the increased value of C3cI and C4I (and IgGI) between the examined groups of the patients was done. Highly significant correlations were found between QAlb and QC3c (r = 0.89, p < 0.001) and QC4 (r = 0.85, p < 0.001). In 22.4% of the examined patients ITS of C3c and C4 were found. There was no difference in frequency of ITS of the two complement proteins between the examined groups, nor inside any particular group. TBC group had significantly lower (p < 0.05) intensity of ITS of C3c and C4 than MNG and ENTERO, and significantly higher intensity of ITS of IgG (p < 0.05) than the other tested groups. CSF index was confirmed as a valid method to detect intrathecal C3c and C4 production. Determination of ITS C3c and C4 could not be of great help in differential diagnosis in the acute serous meningitis syndrome. The intensity of ITS of C3c and C4, related to the intensity of ITS of IgG, could be of help in the determination of the duration of the disease.
Vajaranant, T. S., J. P. Szlyk, et al. (2002). "Localized retinal dysfunction in central serous chorioretinopathy as measured using the multifocal electroretinogram." Ophthalmology 109(7): 1243-50.
PURPOSE: To determine the extent of electrophysiologic dysfunction in patients with central serous chorioretinopathy (CSC). DESIGN: Prospective observational case series. PARTICIPANTS: Six patients with unilateral CSC (mean age, 40 years) were recruited into the study. METHODS: Six patients with CSC underwent multifocal electroretinogram (mfERG) testing on both their clinically affected and opposite uninvolved eyes using the VERIS System, with a stimulus array of 103 scaled hexagons. The first positive peak responses were analyzed within six concentric ring annuli centered on the fovea. Amplitudes and implicit times were compared with those of an age-similar control group. MAIN OUTCOME MEASURES: Local electroretinographic response amplitudes and implicit times within the central 40 degrees with the mfERG. RESULTS: All the clinically uninvolved eyes showed mfERG amplitudes and implicit times within the normal range throughout the central 40 degrees of the retina. All six eyes with CSC showed reduced amplitudes and/or delayed implicit times that were limited to the regions of the macula in which clinical changes associated with CSC were apparent. CONCLUSIONS: We observed electroretinographic changes only in the clinically affected eyes, and these were limited to regions with ophthalmoscopically apparent fundus changes. Our findings do not support the conclusion that functional impairment, as measured by the mfERG, in eyes with CSC extends beyond clinically observed fundus changes. We did not observe abnormal mfERG responses in the clinically normal eyes of such patients.
Huang, S., D. Wu, et al. (2002). "The multifocal electroretinogram in central serous chorioretinopathy." Ophthalmic Physiol Opt 22(3): 244-7.
PURPOSE: To compare multifocal electroretinograms (ERGs) in control subjects and patients with central serous chorioretinopathy (CSC). METHOD: Eighteen eyes of control subjects and 15 eyes affected by CSC were tested with a VERIS Sciences 4.0 system. The average response densities and latencies of six annular retinal regions in control subjects were compared with those with CSC. RESULTS: The N1, P1 average response densities of the first and second annuli were decreased and the N1, P1 latencies of first to third rings were delayed in CSC. CONCLUSION: The multifocal ERG can be used to evaluate retinal dysfunction in CSC.
Suzuki, K., S. Hasegawa, et al. (2002). "Multifocal electroretinogram in patients with central serous chorioretinopathy." Jpn J Ophthalmol 46(3): 308-14.
PURPOSE: To assess local retinal function of macula in patients with central serous chorioretinopathy (CSC). METHODS: Multifocal electroretinograms (ERGs) were recorded in 5 patients with unilateral CSC and 20 normal subjects. The waveforms from the central retina within 5 degrees of visual angle were analyzed. The first negative trough was designated as N1, the first positive peak as P1, and the second trough as N2. RESULTS: The multifocal ERG amplitudes were significantly reduced at the first attack of CSC in all patients compared with the values in the normal controls, for P1-N1 (P <.01) and for P1-N2 (P <.01). Multifocal ERG latencies of the patients significantly increased compared with normal controls, for P1 (P <.01) and N2 (P <.01). After the resolution of retinal detachment, although the multifocal ERG amplitudes increased markedly, they did not improve to the normal level during the follow-up period (4-23 months). CONCLUSIONS: Persistent functional impairment of the retina was found by multifocal ERGs in patients with CSC after the resolution of subretinal fluid. A topographical analysis of the multifocal ERG is useful in the clinical observation of CSC.
Chrapek, O. and J. Rehak (2002). "[Central serous chorioretinopathy. Treatment, differential diagnosis. Part II]." Cesk Slov Oftalmol 58(2): 122-9.
Wang, M. S., B. Sander, et al. (2002). "Retinal atrophy in idiopathic central serous chorioretinopathy." Am J Ophthalmol 133(6): 787-93.
PURPOSE: To study retinal atrophy in idiopathic central serous chorioretinopathy (ICSC). DESIGN: Observational case series. METHODS: Twenty-four eyes in 23 consecutive patients aged 33 to 67 years and 50 eyes in 25 healthy volunteers aged 24 to 70 years were studied. Observational procedures included: biomicroscopy, fundus photography, fluorescein angiography, optical coherence tomography, photocoagulation. Retinal thickness after resolution of detachment, definite attenuation being defined as foveal thickness less than the mean -2 SD in healthy volunteers; duration of symptoms; best-corrected visual acuity (BCVA). RESULTS: Definite retinal attenuation, retinal thickness ranging from 51% to 74% of normal, was found in nine eyes of nine patients with idiopathic central serous chorioretinopathy (ICSC). Their duration of symptoms was longer (P =.0014) and their BCVA was lower (P =.015) than eyes in patients with normal-range foveal thickness who, nevertheless, had thinner foveae than healthy subjects (P =.10). The most severe reduction of foveal thickness, to half the normal (three eyes of three patients), was associated with BCVA 0.5 or less, multifocal retinal pigment epithelial abnormalities, and more than 10 years' duration of symptoms. Retinal attenuation was seen only after a duration of symptoms of more than 4 months, being most pronounced in the photoreceptor layer, particularly in the fovea. CONCLUSION: Foveal attenuation in ICSC is associated with more than 4 months' duration of symptoms and persistent BCVA reduction despite resolution of the serous detachment. We found no other likely cause of atrophy than the prolonged absence of contact between photoreceptors and retinal pigment epithelial cells.
von Ruckmann, A., F. W. Fitzke, et al. (2002). "Abnormalities of fundus autofluorescence in central serous retinopathy." Am J Ophthalmol 133(6): 780-6.
PURPOSE: To report abnormalities of fundus autofluorescence associated with acute and chronic central serous retinopathy (CSR). DESIGN: A prospective cohort study of patients with CSR was undertaken in which the intensity and spatial distribution of fundus autofluorescence were documented. METHODS: Fundus autofluorescence was recorded using a confocal laser scanning ophthalmoscope (cLSO) and the images compared with the fundus appearance and fluorescein angiograms in 69 eyes of 63 subjects with either acute or chronic CSR. Areas of increased and decreased autofluorescence were compared with ophthalmoscopic and fluorescein angiography abnormalities. Thirty patients with focal leakage on angiography and serous retinal detachment or pigment epithelial detachment were designated as having acute CSR. Thirty-three patients with diffuse leakage on fluorescein angiography, but without manifest detachment were classified as having chronic CSR. RESULTS: The mean age was 39 years (range 29-56 years) 14 were female and 49 male. Acute CSR of more than 4 months duration showed a mild diffuse increase in autofluorescence that corresponded with the detached area. The leaking point on the angiogram corresponded to a focal area of intense autofluorescence. In chronic CSR the autofluorescence was very irregular, there being regions with greater and less than the background levels of fluorescence. CONCLUSION: In acute CSR, increased autofluorescence may occur at the site of leakage and in the area of retinal detachment probably indicating an increased metabolic activity of the retinal pigment epithelium (RPE). Decreased or absent autofluorescence in long-standing lesions may indicate reduced metabolic activity of the RPE due to photoreceptor cell loss. Documenting photoreceptor cell loss with autofluorescence imaging may be useful in identifying patients who would not benefit from laser photocoagulation.
Bandello, F., C. Incorvaia, et al. (2002). "Bilateral central serous chorioretinopathy in a patient treated with systemic cortico-steroids for non-Hodgkin lymphoma." Eur J Ophthalmol 12(2): 123-6.
PURPOSE: To describe the concomitant occurrence of systemic cortico-steroid treatment and the development of bilateral central serous chorioretinopathy (CSC), which promptly regressed after the reduction of the drug dosage, up to its scheduled withdrawal. METHODS: Case report. RESULTS: A 46-year-old white male, with a history of monolateral CSC, had a non-Hodgkin lymphoma on his right cheek. Soon after surgical excision of the tumoral lesion, he received a standard post-operative regimen of decreasing intramuscular betamethasone for 25 days, followed by 10 day's withdrawal, then cycles of intravenous cyclophosphamide and vincristine, followed by 7-day oral prednisone, repeated monthly for three months. Fluorescein angiographies at the end of the first oral cortico-steroid cycle and before starting the second, documented the occurrence of bilateral CSC and its regression, which were chronologically related respectively to the cortico-steroid administration and withdrawal. CONCLUSIONS: This case further demonstrates that systemic cortico-steroids can be responsible for the occurrence of CSC. The patient's history should always be checked for any previous CSC episodes. In these subjects, periodical ophthalmoscopic examination is essential to discover early or asymptomatic steroid-related CSC patterns, to prevent complications of the disease.
Schalenbourg, A., A. Leys, et al. (2002). "Corticosteroid-induced central serous chorioretinopathy in patients with ocular inflammatory disorders." Klin Monatsbl Augenheilkd 219(4): 264-7.
BACKGROUND: Development of central serous chorioretinopathy (CSC) following the administration of corticosteroids by diverse routes is a well-known fact. We report acute visual loss after the use of systemic corticosteroids in three patients with long-standing ocular inflammatory disorders in whom CSC could initially be misinterpreted as a worsening of the primary inflammatory condition. METHODS: We analyzed the clinical findings and the fluorescein and indocyanine green (ICG) angiographic signs in those three patients. RESULTS: The first patient had birdshot chorioretinopathy with minimal functional impairment for several years without treatment. When visual acuity and fields deteriorated, systemic corticosteroids were administered resulting in improved inflammatory and functional parameters during the first 2 months. Subsequently, the visual acuity of his left eye decreased due to CSC. The second patient had Vogt-Koyanagi-Harada disease with five episodes of acute inflammation. She was treated each time with systemic corticosteroids, but thrice her visual acuity deteriorated, caused by CSC. The third patient presented with scleritis of his right eye related to relapsing polychondritis. Massive oral corticosteroids were given, soon followed by the development of CSC in the right eye. Fluorescein and ICG angiographic signs were typical for CSC in all three patients. Cyclosporine was introduced in the two first patients and cyclophosphamide in the third patient, in parallel with tapering of oral corticosteroids. Progressive regression of CSC occurred in all three patients. CONCLUSION: The potentially deleterious effects of corticosteroids, favoring CSC, are well-known. They should be borne in mind when an unexpected clinical and angiographic evolution compatible with CSC develops in an uveitis patient treated with corticosteroids.
Otsuka, S., N. Ohba, et al. (2002). "A long-term follow-up study of severe variant of central serous chorioretinopathy." Retina 22(1): 25-32.
PURPOSE: To facilitate understanding of the long-term course and visual outcome of a severe variant of central serous chorioretinopathy. DESIGN: Consecutive observational case series. PATIENTS AND METHODS: The authors reviewed 25 patients with multifocal posterior pigment epitheliopathy and bullous retinal detachment, who had a mean follow-up time of 10.6 years (range, 6-22 years), with reference to the demographic feature, fundus changes, recurrence, and final anatomic and visual outcome. Two patients underwent optical coherence tomography. RESULTS: The patients were 21 men and 4 women, with a mean age at disease onset of 43.1 years (range, 30-63 years). Twenty-one patients were otherwise healthy, and four developed ocular disease during systemic corticosteroid therapy for metabolic or autoimmune diseases including systemic lupus erythematosus. The disease was bilateral in 21 patients (84%). Nine patients (36%) presented initially with classic central serous chorioretinopathy, followed by its severe variant 7 months to 9 years later. Active disease was characterized by multifocal exudative lesions in the posterior pole and bullous retinal detachment with shifting subretinal fluid in the inferior periphery. Optical coherence tomography of exudative lesions disclosed cloudy and fibrinous subretinal fluid. The exudative lesions were self-limited or responded to photocoagulation. During the follow-up period, 13 patients (52%) showed 1 to 5 recurrent disease, but the disease eventually became quiescent with multifocal atrophic scars in the posterior pole with or without atrophic tracts in the inferior periphery. Final best-corrected visual acuity was 2020 or better in 24 of 46 affected eyes (52%) of 25 patients and 2040 or better in 37 eyes (80.4%). CONCLUSIONS: A severe variant of central serous chorioretinopathy characterized by multifocal posterior exudations and bullous inferior retinal detachment with shifting subretinal fluid may affect otherwise healthy, middle-aged males or individuals receiving systemic corticosteroid therapy for metabolic or autoimmune diseases. Exudative chorioretinal lesions are self-limited or respond to photocoagulation. Recurrence is common, but the disease eventually becomes quiescent with favorable visual acuity unless the macula is damaged.
Loo, R. H., I. U. Scott, et al. (2002). "Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy." Retina 22(1): 19-24.
PURPOSE: To investigate factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy (ICSC). METHODS: Retrospective consecutive case series that included patients with ICSC who were younger than 50 years of age at the time of initial examination and were followed up for > or =3 years. RESULTS: The mean follow-up for 101 involved eyes of 61 patients was 9.8 years (median, 8.0 years). Eyes were stratified into two groups based on visual acuity at the final examination: Group 1, visual acuity of 2040 or better; and Group 2, visual acuity of worse than 2040. Findings identified as potential risk factors for reduced vision at the final follow-up examinations for Group 1 versus Group 2 included the following: macular retinal pigment epithelium atrophy (90.8% versus 96.0%, respectively; P = 0.68); persistent pigment epithelial detachment or persistent subretinal fluid (5.3% versus 28.0%, respectively; P = 0.004); recurrences (39.5% versus 68.0%, respectively; P = 0.020); laser treatment (28.9% versus 32.0%, respectively; P = 0.80); and submacular choroidal neovascularization (0.0 versus 8.0%, respectively; P = 0.059). CONCLUSIONS: Factors associated with reduced visual acuity during long-term follow-up of patients with ICSC included persistent pigment epithelial detachment and/or subretinal fluid, recurrences, and submacular choroidal neovascularization.
Giusti, C. (2001). "[Central serous chorioretinopathy: a new extragastric manifestation of Helicobacter pylori?: Analysis of a clinical case]." Clin Ter 152(6): 393-7.
Central serous chorioretinopathy is classically characterized by a shallow, round, serous detachment of the macular retina. It preferentially affects men between 20 and 45 years of age and recurrences have been documented in most cases. Although the aetiopathogenesis of the disease is still unknown, it has been thought to be due to a focal leakage from one or more defects in the retinal pigment epithelium, which allow serous fluid from the choriocapillaris to diffuse into the subretinal space. Moreover, it is theorized that damage of the active fluid transport mechanisms through the retinal pigment epithelium may also play a contributing role. Finally, the reported correlation with psychophysical stress provides support for the concept of the disease being "adrenergically conditioned". Recently, an interesting association has been observed between this chorioretinal pathology and the Helicobacter pylori infection and, consequently, a new etiological hypothesis has been proposed. Here we report a retrospective analysis of a clinical case of central serous chorioretinopathy with Helicobacter pylori positivity.
Chrapek, O. and J. Rehak (2002). "[Central serous chorioretinopathy. Etiopathogenesis, clinical picture, diagnosis. Part I]." Cesk Slov Oftalmol 58(1): 61-7.
Chrapek, O. and J. Rehak (2002). "[Treatment of central serous chorioretinopathy--personal experience]." Cesk Slov Oftalmol 58(1): 51-6.
On a group of 18 eyes the authors evaluate their experience with medicamentous and laser therapy of central serous chorioretinopathy. They report unsatisfactory results in the group of patients treated with non-steroid antiphlogistics, resorbents, vasoprotective agents, vitamins, where they observed adherence of ablated neuroepithelium in 4 eyes on average after 5.5 weeks. But in 7 similarly treated eyes adherence of the ablation did not occur even after 4 months. The authors confirm the value of direct laser photocoagulation for reducing the period of ablation in central serous chorioretinopathy. In all 11 photocoagulations of treated eyes the ablation adhered on average after 5.2 weeks. The authors maintain that they achieved better final visual acuity and greater improvement of visual acuity in patients where the ablation period of the neuroepithelium was shorter than in patients with a prolonged course of ablation.
Shang, Q., C. Liu, et al. (1999). "[Wavelength selection in management of central serous chorioretinopathy]." Chung Hua Yen Ko Tsa Chih 35(6): 413-5.
OBJECTIVE: To compare the effects of three kinds of laser wavelength in management of central serous chorioretinopathy (CSCR). METHOD: 89 patients with CSCR were randomly divided into three groups according to different wavelengths used. Visual acuity, fundus, fundus fluorescein angiography (FFA), light sensitivity, central visual field were performed before and after laser therapy. RESULT: Compared with red and green wavelength groups, in yellow group the visual acuity, light sensitivity were improved more significantly (P < 0.05), and the disease course was shortened, the effects in recurrence rate were similar in the three wavelength groups. CONCLUSION: In the three kinds of waves, yellow and red have similar and positive effects in the treatment of CSCR.
Shang, Q., C. Liu, et al. (1999). "[Determination of cortisol in plasma and 24-hour urine of patients with central serous chorioretinopathy]." Chung Hua Yen Ko Tsa Chih 35(4): 297-9.
OBJECTIVE: To study the cortisol levels in patients with central serous chorioretinopathy (CSCR). METHODS: Endogenous cortisol levels in plasma and urine were determined in 44 patients with CSCR by radioimmunoassay and chromatography, and their results were compared with that of 41 controls. RESULTS: In acute CSCR, the mean values of the plasma cortisol (296.53 plus minus 77.03) ng/ml and 24-hour urine 17-hydroxysteroids (the major metabolite of cortisol metabolism) (12.08 plus minus 4.82) mg/24 h revealed significantly higher values in the patient group (P < 0.05). CONCLUSIONS: Increased levels of endogenous cortisol play a role in the development of CSCR.
Perkins, S. L., J. E. Kim, et al. (2002). "Clinical characteristics of central serous chorioretinopathy in women." Ophthalmology 109(2): 262-6.
PURPOSE: To describe the clinical features of central serous chorioretinopathy (CSC) in women and identify factors predictive of complete recovery, moderate visual loss, and prolonged duration. DESIGN: Retrospective observational case series. PARTICIPANTS: Eighty-four eyes in 78 women with CSC seen in our practices between 1982 and 1999. METHODS: Univariate and multivariate statistical analysis. MAIN OUTCOME MEASURES: Analyses of three outcome parameters: complete recovery (recovery of visual acuity and complete symptom resolution), moderate visual acuity loss (final acuity less than 20/40), and duration of symptoms greater than 5 months. RESULTS: Sixty-two percent (52 of 84) achieved complete recovery over a median of 5 months (range, 2-108 months) and 88% (74 of 84) had a final vision of 20/40 or better. Patients with subretinal precipitates (P = 0.001), single occurrence (P = 0.002), absence of hormone replacement therapy (HRT) (P = 0.01), duration less than 5 months (P = 0.02), or absence of a pigment epithelial detachment (PED) (P = 0.05) were more likely to recover completely. Recurrence (P = 0.03) and lack of subretinal precipitates (P = 0.03) were associated with a final vision less than 20/40. Age older than 50 (P = 0.004) and the presence of a PED (P = 0.02) were associated with duration longer than 5 months. CONCLUSIONS: In women, CSC associated with subretinal precipitates, shorter duration, single occurrence, lack of HRT use, and absence of PED is more likely to resolve completely. CSC occurring in women older than 50 or associated with PED formation is more likely to take longer to resolve.
Vukojevic, N., J. Sikic, et al. (2001). "Types of central serous retinopathy, analysis of shape, topographic distribution and number of leakage sites." Coll Antropol 25 Suppl: 83-7.
The analysis of 212 fluorescein angiograms of the same number of eyes showed that Type I is by far the most prevalent form of central serous retinopathy. Type I appeared in 92.45%, Type II in 6.60% and the Intermediate type in 0.95% of the examined eyes. The patients were mostly male (81.13%) between 30 and 49 years of age (95.28%). The number of leakage sites in Type I central serous retinopathy varied from 1 (83.67%) to 5 (1.02%). Solitary leakage appeared in 83.67%, while uniform spreading of fluorescein into the subretinal blister in Type I central serous retinopathy appeared in 85.71% of eyes. Most leakage sites (32.50%) were located in the upper nasal quadrant, while the lower temporal quadrant was least affected (15.83%). The foveal avascular zone was affected in 4.14% and the papillomacular bundle in 20.83% of the examined eyes.
Iida, T., R. F. Spaide, et al. (2002). "Leopard-spot pattern of yellowish subretinal deposits in central serous chorioretinopathy." Arch Ophthalmol 120(1): 37-42.
OBJECTIVE: To describe clinical and angiographic features of patients with central serous chorioretinopathy (CSC) who had yellowish subretinal deposits forming a reticulated leopard-spot pattern during fluorescein angiography. METHODS: We conducted case studies using the clinical and photographic records of 5 patients. RESULTS: All 5 patients were older men between the ages of 68 and 81 years who had been treated with corticosteroids and had bilateral CSC. Nine eyes of the 5 patients developed yellowish deposits in a reticulated pattern in the macular region under the chronic detached neurosensory retina. The pattern of leopard-spot deposits was well demonstrated on the fluorescein angiogram, with hypofluorescence in most of the deposits and hyperfluorescence from atrophy of the retinal pigment epithelium. Later phases of the fluorescein angiographic study showed leaks from the retinal pigment epithelium. During the indocyanine green angiography evaluation of 4 patients, all had bilateral multifocal patches of hyperfluorescence in the midphase, findings typical of CSC. CONCLUSIONS: Yellowish deposits forming a reticulated leopard-spot pattern may occur under the neurosensory retina and are associated with chronic neurosensory detachment caused by CSC. All patients were older men being treated with corticosteroids. This report described a newly recognized finding: the subretinal deposition of a yellowish material in a leopard-spot pattern in eyes with CSC.
Mason, J. O., 3rd (2001). "Central serous retinopathy following long-duration laser pointer exposure." South Med J 94(11): 1139-40.
Dohrmann, J., A. Lommatzsch, et al. (2001). "[Pathogenesis of central serous chorioretinopathy: angiographic and electrophysiological studies]." Ophthalmologe 98(11): 1069-73.
BACKGROUND: By the combination of fluorescein and indocyanine green angiography and multifocal electroretinography (mERG) we examined the correlation of angiographic and electrophysiological findings in acute central serous choroiditis (CSC) to find out if this leads to further information about the course of the disease. MATERIAL AND METHODS: Patients with unilateral, acute CSC (n = 49) were examined by the use of fluorescein and indocyanine green angiography and mERG. The examinations were repeated after 6 and 12 weeks. RESULTS: Of the patients 47 (96%) showed hypofluorescent areas in the early pictures of the ICG angiography which changed to hyperfluorescence in the late phase pictures in 39 patients (80%). Of the asymptomatic paired eyes, 31 (63%) showed abnormalities in the ICG pictures. The amplitudes in mERG were reduced in the study eyes as well as in the paired eyes and only recovered slowly. Angiographic healing was seen in 44 (90%) patients during the follow-up time, while the reduction of mERG amplitudes recovered more slowly and did not reach normal levels. CSC is a bilateral disease of the central choroid with acute decompensation of the retinal pigment epithelium in one eye. This leads angiographically to a local hypofluorescence with subsequent hyperfluorescence caused by barrier breakdown. The functional recovery follows the morphological healing only slowly. The mERG seems to be an adequate measurement method.
Paspatis, G. A., P. Koutentakis, et al. (2001). "Crohn's disease complicated by central serous retinopathy." Dig Dis Sci 46(10): 2219-21.
Hassan, L., C. Carvalho, et al. (2001). "Central serous chorioretinopathy in a patient using methylenedioxymethamphetamine (MDMA) or "ecstasy"." Retina 21(5): 559-61.
Iida, T., R. F. Spaide, et al. (2001). "Central serous chorioretinopathy after epidural corticosteroid injection." Am J Ophthalmol 132(3): 423-5.
PURPOSE: To report three patients who developed central serous chorioretinopathy after epidural corticosteroid injection for treatment of back pain. DESIGN: Interventional case series. METHODS: Three men, aged 73, 52, and 73 years, presented with bilateral central serous chorioretinopathy after corticosteroid injection in the epidural space for treatment of back pain. In all three cases, we did not initially elicit the history of corticosteroid use. RESULTS: Two of the three patients, aged 52 and 73 years, had diffuse retinal pigment epitheliopathy and one, aged 73 years, had classic central serous chorioretinopathy. Two patients had a spontaneous resolution of the subretinal fluid in both eyes. One patient had laser photocoagulation in both eyes but continued to have diffuse leakage in one eye. CONCLUSIONS: A careful history to determine corticosteroid use, including possible intrajoint and epidural injection, should be performed in older people with serous detachment of the macula, particularly when bilateral.
Lin, J. M. and Y. Y. Tsai (2001). "Retinal pigment epithelial detachment in the fellow eye of a patient with unilateral central serous chorioretinopathy treated with steroid." Retina 21(4): 377-9.
Bujarborua, D. (2001). "Long-term follow-up of idiopathic central serous chorioretinopathy without laser." Acta Ophthalmol Scand 79(4): 417-21.
PURPOSE: The purpose of this study was to observe the varied types of manifestations in the fundus of patients with idiopathic central serous chorioretinopathy (ICSC) without laser treatment and also to assess the ultimate visual outcome in such cases in a long-term follow-up ranging from 7 to 23 years. METHODS: This study is confined to 5 selected cases of ICSC which fairly represent the different types of late stage manifestations of the disease in the fundus. Case records from our hospital, as well as available records of previous treatment elsewhere were reviewed. A complete ophthalmological examination, routine laboratory investigations and fluorescein fundus angiography (FFA) were repeated in each case on the day of final evaluation. RESULTS: Pigmentary disturbances in the macular area resembling to some extent age-related macular degeneration (AMD), extensive retinal pigment epithelial (RPE) atrophy and macular haemorrhage have been observed in the fundus of the reviewed cases. CONCLUSIONS: ICSC runs an unpredictable course and there are no definitive clinical clues to predict its ultimate outcome. Recurrence of the condition is a possibility for a considerable period of time.
Birchall, W., S. J. Charles, et al. (2001). "Cyclical central serous chorloretinopathy associated with cystoid macular oedema." Br J Ophthalmol 85(6): 756-8.
Katsimpris, J., G. Donati, et al. (2001). "[Value of indocyanine green angiography in detection of central serous chorioretinopathy]." Klin Monatsbl Augenheilkd 218(5): 335-7.
INTRODUCTION: Central serous chorioretinopathy (CSC) is a relatively common and self-limited disease affecting more commonly young adult males who are likely to have a type A personality. The aim of our study was to analyze indocyanine green (ICG) angiographic findings in CSC and correlate them with the biomicroscopical and Fluoresceine angiography (FA) findings in the affected and non affected eyes. PATIENTS AND METHODS: Our study included 19 consecutive patients, that were affected by CSC. The mean age of the patients was 44 years (range 35-50 years). In thirteen patients, in one eye typical acute lesions were observed, and in six patients presented chorioretinal inactive lesions. Angiographic ICG and FA findings of both eyes were compared. RESULTS: In 13 eyes (68%) presenting with the active form of CSC a classic focal leak with a smokestack phenomenon was seen in FA. The leaking point was identified in both FA and ICG, in 9 out of 13 eyes (70%). Surrounding the FA leaking point, an hyperfluorescent plaque in ICG was associated in 12 out of 13 (92%) eyes with active lesions. In 8 out of 13 (62%) controlateral eyes of this group, hyperfluorescent plaques in ICG were also observed. All eyes with inactive FA lesions (6 out of 6), expressed an hyperfluorescent plaque in ICG. DISCUSSION: ICG hyperfluorescence appears in the affected and the fellow eyes in areas where no clinical or FA signs of active disease were present. The persistence of abnormal ICG findings in all the cases of inactive disease suggest that CSC could be not a recurrent but a chronic disease.
Fawzi, A. A. and E. T. Cunningham, Jr. (2001). "Central serous chorioretinopathy after bone marrow transplantation." Am J Ophthalmol 131(6): 804-5.
PURPOSE: To describe central serous chorioretinopathy after bone marrow transplantation. METHODS: The medical records of the patient were reviewed retrospectively. RESULTS: A 46-year-old Filipino man developed multifocal central serous chorioretinopathy affecting his left eye 4 months after bone marrow transplantation for acute myelogenous leukemia. Other co-existing medical problems at the time of presentation included systemic hypertension and graft-versus-host-disease (GVHD), for which the patient was using both systemic corticosteroids and cyclosporine. CONCLUSION: Central serous chorioretinopathy is a rare cause of vision loss in patients after bone marrow transplantation. Previous descriptions of bone marrow transplantation-associated central serous chorioretinopathy in patients with thrombotic microangiopathy, as well as the occurrence of both systemic hypertension and the use of systemic corticosteroids and cyclosporine in our patient with bone marrow transplantation-associated central serous chorioretinopathy, support theories of choroidal vascular compromise in the pathogenesis of central serous chorioretinopathy.
Ahuja, R. M., S. M. Downes, et al. (2001). "Polypoidal choroidal vasculopathy and central serous chorioretinopathy." Ophthalmology 108(6): 1009-10.
Nishiyama, Y., K. Mori, et al. (2001). "Quantitative Analysis of Indocyanine Green Angiographic Image in Central Serous Chorioretinopathy." Jpn J Ophthalmol 45(1): 116.
Purpose: To disclose the possible involvement of choroidal vascular change in developement of central serous chorioretinopathy (CSC).Methods: Indocyanine green (ICG) angiography was performed in 31 eyes with acute CSC, and 21 eyes from normal subjects. The maximum diameter of the choroidal veins and intensity of background fluorescence in the posterior fundus with ICG video images were measured for further analysis using IMAGEnet((R)) (Topcon). Then the results from CSC affected eyes, their fellow eyes, and normal eyes were compared. Aging factors were taken into consideration when we analyzed the data.Result: The maximum diameters of the choroidal veins were larger in both affected and fellow eyes than in the normal eyes (P <.001), and had a positive correlation with aging particularly in fellow eyes (r = 36). Both in the affected and fellow eyes, the background fluorescein intensity in the posterior pole of the late phase images was lower than in the normal eyes (P <.001), and was correlated with aging (r = 0.28, r = 0.43).Conclusion: This quantitative study showed that choroidal venous dilatation and the residual background fluorescence in the posterior fundus might be positive findings reflecting the pathogenesis of CSC.
Shanmugam, M. P. and M. Bhende (2000). "Retinal pigment epithelial tears associated with idiopathic central serous chorioretinopathy." Indian J Ophthalmol 48(4): 315-7.
Two patients with idiopathic central serous chorioretinopathy with retinal pigment epithelial tears are described.
Weenink, A. C., R. A. Borsje, et al. (2001). "Familial chronic central serous chorioretinopathy." Ophthalmologica 215(3): 183-7.
Twenty-seven patients with characteristic, mostly bilateral, fundus lesions of chronic central serous chorioretinopathy (CSC) and a progressive course, and 80 of their relatives, mainly siblings, were examined. Ophthalmologic examination included assessment of visual acuity, Amsler grid testing, ophthalmoscopy and fluorescein angiography. The fundus findings were classified as normal fundus, multiple areas of retinal pigment epithelium (RPE) atrophy or chronic CSC: RPE atrophy with leakage of fluorescein. In 14 (52%) of the 27 families, 1 or more relatives were affected. Thirty-five (44%) of the 80 investigated relatives had fundus lesions: 22 had chronic CSC in one eye, 20 of these had chronic CSC or RPE atrophy in the fellow eye. Thirteen relatives had RPE atrophy in one or both eyes. The mode of inheritance could not be established.
Kwok, A. K., T. Y. Lai, et al. (2001). "Massive subretinal haemorrhage associated with central serous chorioretinopathy." Eye 15(Pt 1): 121-3.
Wynn, P. A. (2001). "Idiopathic central serous chorioretinopathy--a physical complication of stress?" Occup Med (Lond) 51(2): 139-40.
The adverse psychological sequelae of stress are well recognized by occupational health specialists. Potential adverse physical effects, such as ischaemic heart disease, are more contentious but are biologically plausible. This report outlines a case of idiopathic central serous chorioretinopathy (ICSC), an uncommon but potentially sight-threatening condition, which is widely accepted amongst ophthalmologists to be stress related. The condition is not referred to in standard occupational health texts or databases. The report includes a brief review of the ophthalmological literature on which the connection between ICSC and stress has been made, and a need for further research promoted.
Chaine, G., M. Haouat, et al. (2001). "[Central serous chorioretinopathy and systemic steroid therapy]." J Fr Ophtalmol 24(2): 139-46.
BACKGROUND: The manifestations of the ocular toxicity of systemic corticosteroids include posterior subcapsular cataracts and glaucoma. We describe 14 cases of serous detachment of the macula due to central serous chorioretinopathy in patients given long-term steroid therapy, which may be another potential ocular side effect of corticosteroid. Cases report: The 14 (9 men and 5 women) patients were aged from 39 to 55 year old. Their systemic diseases were allergic thrombopenic purpura, optic neuritis, kidney or heart transplant, Churg and Strauss vasculitis, facial palsy, rheumatoid arthritis, systemic lupus and a kidney tumor. None of the patients had hypertension. RESULTS: Serous detachment occurred between 6 days and 10 years after the start of steroid treatment. The higher the doses, the earlier the onset of ocular disease. All patients were symptomatic, with rapid onset of blurred vision. Serous detachment was bilateral in two cases. The fluorescein angiographic finding was in most cases a single small focal hyperfluorescent leak from the retinal pigment epithelium which appeared early in the angiogram and increased in size and intensity. No diffuse degradation of the retinal pigment epithelium was seen on the fluorescein angiogram. Five patients underwent laser photocoagulation of the leaking area followed by resorption of subretinal fluid. In other patients, the symptoms disappeared as the doses of steroid were reduced. CONCLUSION: The pathogenesis of central serous chorioretinopathy remains unclear and is controversial. Corticosteroids are known to worsen the prognosis of idiopathic central serous chorioretinopathy, and serous detachment has been reported after renal transplantation. In most of these cases, chorioretinopathy was combined with diffuse leakage from the choriocapillaris. We discuss the relationship between steroid therapy and focal leakage as seen in idiopathic central serous chorioretinopathy. In conclusion, we describe 14 cases of central serous retinopathy whose clinical and fluorescein angiography were fairly typical, without obvious diffuse degradation of the retinal pigment epithelium. All these patients had been given long-term steroid therapy for various diseases.
Simon, P., A. Glacet-Bernard, et al. (2001). "[Choroidal neovascularization as a complication following laser treatment of central serous chorioretinopathy]." J Fr Ophtalmol 24(1): 64-8.
We report the case of a 39-year old man who presented with central serous chorioretinopathy. Two months after diagnosis, argon laser photocoagulation was performed. One month later, the patient noticed distortion and a reduction in vision revealing a subretinal neovascularization above the fovea next to the laser scar. The patient underwent surgical extraction of the neovascular membrane and recovered a visual acuity of 20/30. This case report shows a complication of laser treatment of central serous chorioretinopathy and underlines the diagnostic difficulties of this disease and its treatment modalities. The surgical excision, the first reported in this etiology, led to good visual recovery, as is usually observed in young patients operated on for neovascular membrane.
Dada, T. (2000). "Systemic findings associated with central serous chorioretinopathy." Am J Ophthalmol 130(3): 379.
Bek, T. and M. Kandi (2000). "Quantitative anomaloscopy and optical coherence tomography scanning in central serous chorioretinopathy." Acta Ophthalmol Scand 78(6): 632-7.
BACKGROUND: Dyschromatopsia is a prominent sign in a variety of central retinal diseases, such as central serous chorioretinopathy (CSC). The changes in colour vision may be due to either optical or neuronal factors in the diseased retina. The relative contribution from the two causes is unknown, but may be elucidated by obtaining knowledge of the anatomical derangement in the diseased retina in CSC. METHODS: Twenty-six normal persons had their colour vision tested using the Tomey anomaloscope. The calculation of setting range (SR) and central mean point (CMP) for Rayleigh match and Moreland match was optimized, and normal ranges for these values were defined. Subsequently 24 patients with CSC were examined by anomaloscopy and optical coherence tomography scanning, and the measures of colour vision were related to the anatomical changes observed on the scans. RESULTS: The algorithm for calculating SR and CMP which is integrated into the Tomey anomaloscope could be considerably improved to increase sensitivity and reproducibility of these measures. Fifteen patients had abnormal colour vision. Nine patients had pseudo-protanomaly, seven patients had pseudo-tritanomaly, and three patients had abnormalities in both matches. There was no relation between these colour vision abnormalities and the anatomical derangement as seen by OCT in the diseased central retina. CONCLUSION: The findings argue against the notion that the density of retinal cell nuclei, the orientation of photoreceptors, or the size of the central serous detachment are related to the colour vision abnormalities in CSC. The question of whether these abnormalities are due to optical or neuronal factors remains open.
Torron, C., B. Melcon, et al. (2000). "[Central serous choroidopathy. Long term study]." Arch Soc Esp Oftalmol 75(2): 103-8.
PURPOSE: To investigate the demographic characteristics, clinical findings and long-term outcome of central serous chorioretinopathy (CSC). METHODS: This study examined retrospectively the clinical stories and fluorescein angiographies of 113 patients with CSC and a minimum follow-up of 12 months. RESULTS: A total of 113 patients was examined; 90 were men and 23 women. Bilateral involvement was found in 13 cases. In 85.7% of the eyes (Group I) resolution was completed in months and mean final visual acuity (VA) was 79.3/100, while 14.3% of the eyes (Group II) showed a chronic evolution, with diffuse retinal pigment epithelipathy and mean final VA of 47.2/100. The mean age of the patients in Group II was significantly higher; male:female ratio was also higher in this Group. Bilateral involvement occurred in 6% of patients from Group I and in 46.6% in Group II. CONCLUSIONS: Chronic CSC affected less than 15% of the patients. Mean age in this group of patients was higher than in patients with a classic CSC, most of the cases were men, bilateral involvement was present in nearly 50% of the cases and 50% of them suffered a significant visual permanent impairment.
Lin, E., P. G. Arrigg, et al. (2000). "Familial central serous choroidopathy." Graefes Arch Clin Exp Ophthalmol 238(11): 930-1.
Maaranen, T. H., K. T. Tuppurainen, et al. (2000). "Color vision defects after central serous chorioretinopathy." Retina 20(6): 633-7.
PURPOSE: To reexamine patients diagnosed with central serous chorioretinopathy (CSC) during the 10-year period from 1987 to 1996 to identify remaining color vision defects in the eyes with normal visual acuity (VA). METHODS: Thirty-nine patients were found with normal VA of 20/20 (logMAR 0) or better 8 to 166 months (mean +/- SD, 58.8 +/- 41.2) after active CSC. Color vision was examined with the Standard Pseudoisochromatic Plates part 2, Farnsworth-Munsell 100 hue test, and Color Vision Meter 712 anomaloscope. RESULTS: Of the CSC eyes, 26 (67%) had a color vision defect, most of them in the blue area. There was no correlation between the time since the active disease and the results on the color vision tests. Of the contralateral eyes, 19 (49%) also had a color vision defect. CONCLUSION: In many patients some degree of color vision defect remains after CSC even if the VA has recovered to normal. The contralateral eye can also have a color vision defect. This has not been previously reported and might be due to earlier subclinical CSC.
Adan, A. and B. Corcostegui (2001). "Surgical management of exudative retinal detachment associated with central serous chorioretinopathy." Ophthalmologica 215(1): 74-6.
Suzuki, K., S. Hasegawa, et al. (2000). "Multifocal Electroretinogram in Central Serous Chorioretinopathy." Jpn J Ophthalmol 44(5): 571.
Purpose: An assessment of retinal function topographically in the affected eyes with central serous chorioretinopathy (CSC).Participants and Method: We recorded multifocal electroretimogram (mERG) in 5 patients with unilateral CSC, and analyzed the topographical properties in the central visual field (rings #1 + 2).Results: mERG amplitudes in the CSC eyes were significantly reduced compared with the fellow eyes, for P 1-N 1 (58.5 +/- 23.5%, p < 0.05) and for P 1-N 2 (47.5 +/- 15.0%, p < 0.05). mERG latencies in the CSC eyes were significantly increased compared with those in the fellow eyes, for N 1 (by 9.0 +/- 8.1%, p < 0.05) and for P 1 (by 8.4 +/- 7.0%, p < 0.05). mERG in the CSC eyes gradually recovered in the follow-up period. However, the responses did not recover to normal value during follow-up, even when the subretinal fluid disappeared ophthalmoscopically.Conclusions: These results show that a topographical analysis of the mERG is useful for clinical observation of CSC.
Khng, C. G., E. Y. Yap, et al. (2000). "Central serous retinopathy complicating systemic lupus erythematosus: a case series." Clin Experiment Ophthalmol 28(4): 309-13.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with widespread manifestations including the eye. Central serous retinopathy (CSR) has been associated as a complicating event in SLE, although it is uncommon. We present a case series of four female Chinese SLE patients who developed CSR during the course of their systemic disease. All four presented clinically with typical CSR. Angiographic findings did not show evidence of choroidal ischaemia or delayed choroidal filling. Resolution of the serous retinal detachment occurred in all four patients. Recovery of vision was seen in three patients. The clinical outcome was similar to that occurring in the usual male population. Central serous retinopathy as a manifestation of SLE may be caused by various factors. These include SLE-associated choroidopathy, systemic hypertension, renal disease, retinal pigment epithelial dysfunction and glucocorticoid therapy.
Maaranen, T. and M. Mantyjarvi (1999). "Contrast sensitivity in patients recovered from central serous chorioretinopathy." Int Ophthalmol 23(1): 31-5.
OBJECTIVE: To study contrast sensitivity in patients who have recovered from central serous chorioretinopathy (CSC). PATIENTS AND METHODS: Thirty-one patients who had recovered from CSC were examined with the Vistech and Pelli-Robson contrast sensitivity charts. The time from the onset of the active disease varied from 10 to 166 months (mean 60.4 +/- 42.0, SD). The visual acuity was 1.0 (logMar 0) or better. RESULTS: Contrast sensitivity of the affected eyes was significantly worse in the intermediate spatial frequencies of 3 and 6 cycles per degree (cpd) in the Vistech test compared to the fellow eyes (p = 0.032, 0.013, respectively). Contrast sensitivity of the affected eyes was significantly worse in all 5 spatial frequencies of the Vistech test and in the Pelli-Robson test compared to age-matched normal eyes (p = 0.006, 0.000, 0.000, 0.018, 0.000, 0.000, respectively). Contrast sensitivity of the fellow eyes was significantly worse in the spatial frequencies of 3 and 18 cpd in the Vistech test and in the Pelli-Robson test compared to age-matched normal eyes (p = 0.020, 0.019, 0.000, respectively). CONCLUSIONS: Contrast sensitivity does not seem to recover in all eyes after CSC even if the visual acuity has returned to normal. Therefore, contrast sensitivity testing is recommended for the patients complaining of visual impairment in spite of good visual acuity.
Cooper, B. A. and M. A. Thomas (2000). "Submacular surgery to remove choroidal neovascularization associated with central serous chorioretinopathy." Am J Ophthalmol 130(2): 187-91.
PURPOSE: To report the results of submacular surgery for removal of choroidal neovascularization associated with central serous chorioretinopathy. METHODS: Ten eyes of nine consecutive patients with central serous chorioretinopathy and subfoveal or juxtafoveal choroidal neovascularization underwent pars plana vitrectomy with removal of the choroidal neovascular membrane between January 1994 and January 1999.RESULTS: All 10 eyes (nine patients) were followed postoperatively for at least 6 months. The mean postoperative follow-up was 23 months (range, 6 to 56.5 months). The patients were followed for an average of 6.2 months from the time of symptoms to the removal of the choroidal neovascularization. Preoperative mean best-corrected visual acuity was 20/100 (range, 20/25 to 20/400), and postoperative best-corrected mean visual acuity was 20/60 + 2 (range, 20/20 to 20/400). Seven eyes had improved postoperative visual acuity, with an average of 3.4 lines gained. Of the three eyes that had worse acuity, an average of 1.3 lines of visual acuity was lost; final mean postoperative visual acuity was 20/80 + 1 (range, 20/25 to 20/400). Of the six eyes with symptoms of less than 3 months' duration, four had a final visual acuity of 20/50 or better. All three eyes with 20/300 or worse final visual acuity had loss of foveal retinal pigment epithelium after surgery; the remaining eyes had preserved retinal pigment epithelium with a visual acuity of 20/70 or better. Two eyes had intraoperative peripheral retinal tears, and two eyes had recurrence of the choroidal neovascular complex. CONCLUSIONS: The anatomic and visual results in eyes with choroidal neovascularization associated with central serous chorioretinopathy are modestly encouraging and suggest that submacular surgery for choroidal neovascularization in patients with central serous chorioretinopathy is a treatment option that may salvage good macular function in some eyes.
Conrad, R., I. Bodeewes, et al. (2000). "[Central serous chorioretinopathy and psychological stress]." Ophthalmologe 97(8): 527-31.
BACKGROUND: To date we know little about the etiology of central serous chorioretinopathy. Former investigations discussed inadequate coping strategies and critical life-events as important psychological aspects. In this study we investigated the relationship between central serous chorioretinopathy and stress. MATERIALS AND METHODS: 35 male patients with central serous chorioretinopathy (group 1) were compared to 21 male patients with traumatic eye diseases. The evaluated data included sociodemographic data as well as data regarding the patients coping strategies, critical live-events before outbreak of the disease, personality factors and general physical complaints. RESULTS: Group 1 showed a significantly higher amount of general physical complaints, measured with a complaints questionnaire (B-L). In a personality inventory (FPI-R) it scored significantly higher on the scales emotional instability and strain, significantly lower on the scale extraversion. CONCLUSION: The results indicate that patients with central serous chorioretinopathy are more stressed because of inadequate coping strategies, which can be seen in a higher amount of physical complaints.
Constantinides, G. (2000). "[Relation between retinal pigment epithelial detachment and dye leakage in central serous retinopathy]." J Fr Ophtalmol 23(7): 649-54.
PURPOSE: The purpose of this report is to provide supportive evidence favoring the hypothesis of choroidal hyperpermeability in central serous chorioretinopathy. PATIENTS AND METHODS: Seven consecutive patients (eight eyes) with a history of central serous chorioretinopathy were explored. Fluorescein angiography and a monochromatic frame at 640 mm was performed for all eyes. All showed dye leakage located at the rim of a retinal pigment epithelial detachment. RESULTS: Retinal pigment epithelial detachment was extrafoveal in all 8 eyes. Dye leakage was located at the nasal rim in 4 eyes, the superior rim in 2 eyes, the temporal rim in 1 and the anterior rim in the last eye. CONCLUSION: Dye leakage at the rim of pigment epithelial detachment in central serous chorioretinopathy is a strong argument for the hypothesis of a choroidal hyperpermeability. The hyperpressure crushes the overlying retinal pigment epithelium and in some areas provokes focal detachment and dye leakage at the junction of the detached and attached pigment epithelium.
Chappelow, A. V. and M. F. Marmor (2000). "Multifocal electroretinogram abnormalities persist following resolution of central serous chorioretinopathy." Arch Ophthalmol 118(9): 1211-5.
OBJECTIVE: To examine results of the multifocal electroretinogram (MERG) after spontaneous resolution of central serous chorioretinopathy (CSC) detachments. METHODS: Multifocal electroretinograms were recorded from both eyes of 5 recovered patients with CSC and 10 age-matched healthy subjects. All patients with CSC had bilaterally subnormal MERG amplitudes during a first attack of CSC occuring 7 to 23 months earlier. RESULTS: After recovery from CSC, MERG A-wave and B-wave amplitudes increased markedly where the detachment resolved, and moderately elsewhere in the posterior pole of both eyes. However, the signals from both eyes remained either subnormal or low-normal relative to controls. Multifocal electroretinogram B-wave latencies improved from prolonged to mid-normal values in both eyes. CONCLUSIONS: Both eyes of patients with active unilateral CSC exhibit diminished MERG amplitudes. Although MERG response amplitudes increased modestly after recovery from CSC, they remained statistically subnormal throughout the posterior pole of both eyes. These findings support the theory that subretinal fluid retention in CSC is secondary to diffuse pathologic changes in the choroid and/or retinal pigment epithelium. They also suggest that the underlying or predisposing abnormalities of CSC resolved only partially in our patients. Components of the MERG may have value as a prognostic tool for judging the risk of developing symptomatic CSC. Arch Ophthalmol. 2000;118:1211-1215
Nishiyama, Y., K. Mori, et al. (2000). "[Quantitative analysis of indocyanine green angiographic image in central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 104(8): 577-83.
PURPOSE: To disclose the possible involvement of choroidal vascular change in development of central serous chorioretinopathy (CSC). METHODS: Indocyanine green (ICG) angiography was performed in 31 eyes with acute CSC, and 21 eyes from normal subjects. The maximum diameter of the choroidal veins and intensity of background fluorescence in the posterior fundus with ICG video images were measured for further analysis using IMAGEnet (Topcon). Then the results from CSC affected eyes, their fellow eyes, and normal eyes were compared. Aging factors were taken into consideration when we analyzed the data. RESULT: The maximum diameters of the choroidal veins were larger in both affected and fellow eyes than in the normal eyes (p < 0.001), and had a positive correlation with aging particularly in fellow eyes (r = 0.36). Both in the affected and fellow eyes, the background fluorescein intensity in the posterior pole of the late phase images was lower than in the normal eyes (p < 0.001), and was correlated with aging (r = 0.28, r = 0.43). CONCLUSION: This quantitative study showed that choroidal venous dilatation and the residual background fluorescence in the posterior fundus might be positive findings reflecting the pathogenesis of CSC.
Normalina, M., M. Zainal, et al. (1998). "Central serous choroidopathy in pregnancy." Med J Malaysia 53(4): 439-41.
Central serous choroidopathy is a spontaneous serous detachment of the sensory retina, usually affecting adults between 20 to 50 years of age but is also found in patients older than 60 years of age. This disease usually affects males with a male to female ratio of 8-10 to 1. Many aetiological or associated factors have been described. Here we report a 39-year-old pregnant lady presented with left central serous chorioretinopathy preceded by an unusual emotional disturbance. She was not given any photocoagulative treatment to avoid possible photocoagulative complications. Post delivery, she presented with resolution of the CSC.
Bandello, F., C. Incorvaia, et al. (2000). "Idiopathic multiple serous detachments of the retinal pigment epithelium followed by bilateral central serous chorioretinopathy: a case report." Ophthalmologica 214(5): 362-7.
An uncommon case of a 25-year-old woman affected by bilateral idiopathic multiple serous detachments of the macular retinal pigment epithelium is described. During the fluorescein angiography follow-up, in either macular area one of these detachments resulted in a typical central serous chorioretinopathy active leakage point. These findings detail that idiopathic serous detachments of the retinal pigment epithelium may represent predisposing changes for the development of macular neurosensory retinal detachment.
Sibayan, S. A., K. Kobuch, et al. (2000). "Epinephrine, but not dexamethasone, induces apoptosis in retinal pigment epithelium cells in vitro: possible implications on the pathogenesis of central serous chorioretinopathy." Graefes Arch Clin Exp Ophthalmol 238(6): 515-9.
BACKGROUND: The pathogenesis of central serous chorioretinopathy is poorly understood. It is believed to be due to dysfunction of the retinal pigment epithelium and/or choroid and has been associated with elevated levels of epinephrine and administration of corticosteroids. Epinephrine and corticosteroids have previously been shown to induce apoptosis (programmed cell death) in various types of cells. The objective of this study was to investigate whether these agents can induce apoptosis in cultured retinal pigment epithelium cells. This may help elucidate the pathogenesis of central serous chorioretinopathy. METHODS: Third-passage porcine retinal pigment epithelium cells were grown to confluence and incubated for 1-7 days in culture medium containing epinephrine (10(2)-10(9) pg/ml) or a corticosteroid, dexamethasone (4-4x10(4) ng/ml). The cultures were evaluated for apoptosis by phase-contrast microscopy and in situ terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling. RESULTS: Epinephrine (7x10(7)-10(9) pg/ml) induced apoptosis in a dose- and time-dependent manner. Exposure to lower concentrations of epinephrine (10(2)-6x10(7) pg/ml) and all tested levels of dexamethasone did not result in apoptosis. CONCLUSION: Retinal pigment epithelium cells may undergo apoptosis following exposure to elevated levels of epinephrine. These findings suggest a possible pathophysiologic mechanism for the development of central serous chorioretinopathy.
Kwok, A. K., T. Y. Lai, et al. (2000). "Central serous chorioretinopathy complicated by massive bilateral subretinal haemorrhage." Br J Ophthalmol 84(8): 936-7.
Costen, M. T. and J. A. Olson (2000). "Central serous chorioretinopathy may be a manifestation of the primary antiphospholipid syndrome." Br J Ophthalmol 84(6): 667.
Gomez-Ulla, F., J. M. Vazquez, et al. (2000). "Central serous chorioretinopathy following pigment epithelium detachment: fluorescein and indocyanine green angiography follow-up." Acta Ophthalmol Scand 78(2): 232-4.
PURPOSE: To evaluate the evolution from idiopathic serous pigment epithelium detachment (PED) to central serous chorioretinopathy (CSC). METHODS: Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed using the digital imaging system Topcon IMAGEnet H 1024. RESULTS: A leakage point which later became the typical smokestack image of a CSC was found in the upper margin of the persistent PED. Dilation of the choroidal vessels under the detached neuroepithelium was also seen. CONCLUSIONS: Clinical and angiographic evidence about the relation between the two entities can help us to understand CSC as a potential evolution of PED and to continue searching for the common injury of the pigment epithelium which probably is the primary event.
Suzuki, K., S. Hasegawa, et al. (2000). "[Multifocal electroretinogram in central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 104(4): 248-54.
PURPOSE: To assess retinal function topographically in the affected eyes with central serous chorioretinopathy (CSC). PARTICIPANTS AND METHOD: We recorded multifocal electroretimogram (mERG) in 5 patients with unilateral CSC, and analyzed the topographical properties in the central visual field (rings #1 + 2). RESULTS: mERG amplitudes in the CSC eyes were significantly reduced compared with the fellow eyes, for P 1-N 1 (58.5 +/- 23.5%, p < 0.05) and for P 1-N 2 (47.5 +/- 15.0%, p < 0.05). mERG latencies in the CSC eyes were significantly increased compared with those in the fellow eyes, for N 1 (by 9.0 +/- 8.1%, p < 0.05) and for P 1 (by 8.4 +/- 7.0%, p < 0.05). mERGs in the CSC eyes gradually recovered in the follow-up period. However, the responses did not recover to normal value during follow-up, even when the subretinal fluid disappeared ophthalmoscopically. CONCLUSIONS: These results show that a topographical analysis of the mERG is useful for clinical observation of CSC.
Sahu, D. K., P. Namperumalsamy, et al. (2000). "Bullous variant of idiopathic central serous chorioretinopathy." Br J Ophthalmol 84(5): 485-92.
BACKGROUND: Spontaneous bullous serous retinal detachment (RD) with subretinal exudation complicating idiopathic central serous chorioretinopathy (ICSC) is a rare and infrequently described clinical entity. Clinical observations are described on this variant form in 11 patients, the largest series reported to date. METHODS: 13 eyes of 11 Indian patients having this entity were followed up clinically and angiographically for 12-24 months (retrospective, longitudinal). None of the patients had any previous history of other diseases nor were they on any medications. Four eyes received laser treatment (group A); nine eyes were not treated (group B). RESULTS: All 11 patients were male, aged 23-49 years (median 37 years). The clinical and photographic records revealed subretinal exudation and inferior bullous serous RD complicating ICSC with evidence of large, single or multiple, leaking retinal pigment epithelial detachments (PEDs) in all the cases. In group A, resolution of serous RD occurred in 12 weeks (median) with a visual recovery of >/=20/30 in three out of four eyes while in group B resolution of serous retinal detachment was observed in 14 weeks (median) with eight out of nine eyes achieving a visual acuity of >/=20/30. Subretinal fibrosis developed in two eyes in group A and none of the eyes in group B. CONCLUSION: The disease is an exaggerated form of ICSC and can occur spontaneously without any history of corticosteroid therapy. Recognition of this atypical presentation is important to avoid inappropriate treatment. These observations suggest that with respect to the duration of the disease and the final visual outcome laser therapy offers no additional benefit over the natural course of this variant form of ICSC.
Yannuzzi, L. A., K. B. Freund, et al. (2000). "Polypoidal choroidal vasculopathy masquerading as central serous chorioretinopathy." Ophthalmology 107(4): 767-77.
OBJECTIVE: To differentiate polypoidal choroidal vasculopathy (PCV) from central serous chorioretinopathy (CSC). DESIGN: A retrospective, observational case series. PARTICIPANTS: Thirteen patients originally diagnosed with CSC proved to have PCV after more extensive evaluation and follow-up. METHODS: A clinical and angiographic review of patients with manifestations of CSC, including macular detachment. MAIN OUTCOME MEASURES: Demographic data, funduscopic examination, and fluorescein and indocyanine green (ICG) angiographic findings. RESULTS: Thirteen patients initially suspected of having CSC were ultimately diagnosed as having PCV. These eyes had exudative macular detachments secondary to a small caliber, polypoidal choroidal vascular abnormality or so-called polypoidal choroidal neovascularization. The clinical manifestations in the fundus varied. They included multiple, variably sized serous pigment epithelial detachments, neurosensory retinal detachment, lipid deposition, patchy atrophy of the pigment epithelium and indistinct staining from decompensation of the posterior blood-retinal barrier on fluorescein angiography. In reality, the suspected PEDs proved to be polypoidal lesions of PCV when imaged with ICG angiography. CONCLUSIONS: The clinical diagnosis of CSC or PCV generally poses little challenge to the experienced retinal specialist. However, in CSC with persistent and/or recurrent exudation, a myriad of retinal pigment epithelial changes may evolve that make it difficult to differentiate these two entities. In such patients, ICG angiography is useful in differentiating CSC from PCV. An accurate clinical diagnosis is important since each of these entities, CSC and PCV, may differ in terms of their risk factors, natural course, and visual prognosis.
Thoelen, A. M., P. P. Bernasconi, et al. (2000). "Central serous chorioretinopathy associated with a carcinoma of the adrenal cortex." Retina 20(1): 98-9.
Iida, T., N. Hagimura, et al. (2000). "Evaluation of central serous chorioretinopathy with optical coherence tomography." Am J Ophthalmol 129(1): 16-20.
PURPOSE: To evaluate central serous chorioretinopathy with optical coherence tomography during the acute phase and after resolution of the acute phase. METHODS: In a prospective study, 23 consecutive eyes of 23 patients (19 men, four women; mean age +/- SD, 46.0+/-8.1 years; range, 29 to 60 years) with central serous chorioretinopathy were examined with optical coherence tomography during the acute phase and after resolution of the retinal detachment. After the initial examination, the patients were reexamined for 3 to 6 months (mean, 4.7+/-1.1 months). Cross-sectional retinal images through the center of the fovea were obtained from all eyes by optical coherence tomography. The retinal thickness at the center of the fovea was measured. The difference between the retinal thickness during the acute phase and after resolution of the retinal detachment was statistically analyzed using the Wilcoxon test. We also examined a grayish-white lesion that corresponded to the leakage point in fluorescein angiography in four eyes. RESULTS: In the acute phase, neurosensory retina was thickened within the area of serous retinal detachment in all 23 eyes. The detached retina was thicker than the reattached retina after resolution of the retinal detachment in all eyes. The retinal thickness at the center of the fovea during the acute phase (range, 157 to 236 microm; mean +/- SD, 196.9+/-22.6 microm) was significantly thickened compared with that after resolution (range, 105 to 152 microm; mean +/- SD, 124.8+/-10.7 microm; P<.0001, Wilcoxon test). In the acute phase, areas of low reflectivity localized within the detached retina were observed in 18 of the 23 eyes. In the area of the grayish-white lesion, optical coherence tomography showed a moderately reflective mass bridging the detached neurosensory retina and retinal pigment epithelium in the four eyes; the outer layer of the detached retina was more highly reflective in these eyes. The retinal pigment epithelium was focally detached beneath the subretinal reflective mass in three of the four eyes. CONCLUSIONS: In all eyes studied, neurosensory retina was thickened within the area of serous retinal detachment in the acute phase of central serous chorioretinopathy. The grayish-white lesion seems to be a fibrinous exudate that accumulates in the subretinal space and infiltrates into the outer retina.
Lip, P. L., L. Mowatt-Dixon, et al. (1999). "Central serous retinopathy complicated by massive bilateral subretinal haemorrhage." Br J Ophthalmol 83(8): 990-1.
Brodsky, M. C. (1999). "Central serous papillopathy." Br J Ophthalmol 83(7): 878.
Iida, T., S. Kishi, et al. (1999). "Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy." Retina 19(6): 508-12.
BACKGROUND: To clarify the role of choroidal vascular abnormalities in central serous chorioretinopathy (CSC) in active stage, remission, and recurrence. METHODS: Indocyanine green angiography and fluorescein angiography were performed in 105 eyes (104 patients) with active CSC. Forty-six patients were followed up for 6 to 48 months (mean +/- standard deviation, 22.5 +/- 8.9 months) with repeated angiography (mean +/- standard deviation, 3.5 +/- 1.5 times). Indocyanine green angiography and fluorescein angiography also were performed during remission in all 46 eyes with CSC and during recurrent CSC in 6 eyes. Unaffected fellow eyes underwent angiographic examinations in all patients. RESULTS: In active CSC, indocyanine green angiography showed a choroidal filling delay (71%), venous dilation (61%), and focal choroidal hyperfluorescence (96%) surrounding leakage from the retinal pigment epithelium. Focal choroidal hyperfluorescence was present in unaffected areas of affected eyes (55%). The choroidal venous dilation (36%) and choroidal hyperfluorescence (62%) were noted even in unaffected fellow eyes. These choroidal abnormalities persisted during remission after leakage ceased throughout the follow-up period. In the six patients with recurrent CSC, new leakage developed in the areas of persistent choroidal hyperfluorescence. Central serous chorioretinopathy developed in the unaffected fellow eye in one of these six patients. CONCLUSION: Choroidal vascular abnormalities persist in both eyes even after leakage from the retinal pigment epithelium ceases. Central serous chorioretinopathy may recur in areas of choroidal vascular abnormalities.
Boguszakova, J., Z. Gajdosikova, et al. (1999). "[Diffuse retinal pigmented epitheliopathy--a variant of central serous chorioretinopathy of the aged]." Cesk Slov Oftalmol 55(5): 287-95.
The authors describe a group of eight patients (four women and four men) with diffuse retinal pigmented epiteliopathy (four times unilateral and four times bilateral) confirmed by fluoroangiography, in one instance with bullous elevation of the retina. The mean age of the patients was 57.3 years, the investigation period was 4 to 23 years, with a mean of 8.6 years. After laser coagulation which was implemented in four patients vision improved in one instance, in the remaining patients vision was stabilized. In the patient with the bullous elevation of the retina vision improved after spontaneous flattening of the ablation. The authors discuss the pathogenesis and clinical features typical for diffuse retinal pigmented epitheliopathy.
Chen, S. J., A. F. Lee, et al. (1999). "Indocyanine green angiography of central serous chorioretinopathy." Zhonghua Yi Xue Za Zhi (Taipei) 62(9): 605-13.
BACKGROUND: Fluorescein angiography has not been particularly useful in studying the choroidal vasculature because of limited fluorescence transmission through the retinal pigment epithelium (RPE). Indocyanine green (ICG), a dye that absorbs and fluoresces in the near-infrared range and does not leak extensively through the choriocapillaries, because of its highly protein-bound nature, allows improved imaging of the choroid compared with fluorescein angiography. This study was performed to evaluate changes in the choroidal circulation in the eyes of patients with central serous chorioretinopathy (CSCR) using ICG angiography. METHODS: We prospectively performed ICG angiography and fluorescein angiography in 41 eyes with classic or chronic CSCR (diffuse retinal pigment epitheliopathy) to investigate the choroidal abnormalities. RESULTS: The ICG angiographic studies revealed choroidal staining in all eyes of the two forms of CSCR. Classic CSCR (35 eyes), when compared with the chronic form (6 eyes), were associated with more RPE leakage (89% vs 33%; p = 0.008), more prominent ischemic lobules (69% vs 0; p = 0.003), and less late phase hypofluorescent spots (46% vs 100%; p = 0.02). CONCLUSIONS: Choroidal hyperpermeability may be a causative factor of acute or chronic CSCR and may help in the diagnosis of atypical cases of CSCR. The differences in the results between these two types of CSCR using ICG angiography, allowed for a better understanding of the choroidal hemodynamic change than fluorescein angiography.
Tittl, M. K., R. F. Spaide, et al. (1999). "Systemic findings associated with central serous chorioretinopathy." Am J Ophthalmol 128(1): 63-8.
PURPOSE: To determine systemic factors associated with central serous chorioretinopathy. METHODS: In a retrospective study, 230 consecutive patients with central serous chorioretinopathy examined in a referral setting were compared with a historical gender-matched and age-matched control group of 230 patients with ocular findings who were examined in the same referral setting. RESULTS: The median age of the patients was 49.8 years, and of the control subjects, 50.0 years. The male-female ratio for both groups was 2.7:1. Patients with central serous chorioretinopathy were more likely to use psychopharmacologic medications (odds ratio = 2.6; 95% confidence interval = 1.30 to 5.19; P = .0049) and corticosteroids (odds ratio = 3.17; 95% confidence interval = 1.30 to 7.70; P = .0067) and were more likely to have hypertension (odds ratio = 2.25; 95% confidence interval = 1.39 to 3.63; P = .0008) than were the control subjects. CONCLUSIONS: This study identified psychopharmacologic medication use, corticosteroid use, and hypertension as factors associated with central serous chorioretinopathy. These findings reinforce the concept that stress and adaptations to stress play a role in this disorder. The findings of possible associations between central serous chorioretinopathy and both hypertension and corticosteroid usage suggest that these modifiable factors may influence morbidity of central serous chorioretinopathy.
Wang, M., B. Sander, et al. (1999). "Detection of shallow detachments in central serous chorioretinopathy." Acta Ophthalmol Scand 77(4): 402-5.
PURPOSE: To study the correlation between symptoms, clinical findings, fundus photographic morphology, and optical coherence tomography in patients with symptoms of central serous chorioretinopathy, but ambiguous biomicroscopic findings and no late-phase fluorescein angiographic leakage. METHODS: Biomicroscopic slit-lamp examination, greyscale digital fundus photography in red-free illumination, fundus fluorescein angiography, optical coherence tomography, and focal retinal argon laser photocoagulation. Seven consecutive patients aged 32-69 years, of whom four received focal retinal photocoagulation treatment. RESULTS: All patients demonstrated a shallow serous detachment on optical coherence tomography. After treatment the detachment resolved, as did the relative scotoma, the prolonged dark adaptation, and the dyschromatopsia. Micropsia was markedly reduced in all, but not completely eliminated in two of the patients. CONCLUSION: Patients with central serous chorioretinopathy may have shallow foveal detachments that can only be detected by optical coherence tomography, whereas clinical and angiographic signs of detachment may be missing. Classical symptoms coupled with a normal or only mildly reduced visual acuity are highly indicative of the presence of a serous neuroretinal detachment, but fluorescein angiography is necessary to establish the diagnosis and the target for treatment.
Chen, Y., C. Zhang, et al. (1997). "[Indocyanine green angiography in central serous chorioretinopathy]." Zhonghua Yan Ke Za Zhi 33(4): 255-8.
OBJECTIVES: To know the results of indocyanine green angiography (ICGA) in central serous chorioretinopathy (CSC) and approach its pathogenetic mechanisms. METHODS: 20 cases of CSC were examined by scanning laser ophthalmoscope to perform blue laser beam examination, fundus fluorescein angiography (FFA) and indocyanine green angiography. RESULTS: (1) The blue laser beam: The elevation lesions of the sensory retinal and retinal pigment epithelial detachment were clearly found. (2) ICGA: In the early phase, choroidal delayed filling (95.0%), choroidal hyper-perfusion (80.0%), choriocapillary dilatation, and in the late phase, hyperfluorescent spots (95.0%), diffuse choroidal hyperfluorescence (77.5%), abnormal fluorescence over vortex vein were found. (3) FFA demonstrated the hyperfluorescence of the choroidal background and the optic disc. CONCLUSIONS: CSC patients have obvious choroidal circulatory disorder and the ICGA is a good method for the study of the pathogenetic mechanisms of the CSC and its therapeutic evaluation.
Zamir, E. and I. Chowers (1999). "Central serous chorioretinopathy in a patient with cryoglobulinaemia." Eye 13 ( Pt 2): 265-6.
Spalding, J. M. (1999). "Central serous chorioretinopathy and HIV." J Am Optom Assoc 70(6): 391-8.
BACKGROUND: Patients with central serous chorioretinopathy (CSC) have sudden-onset, painless, uniocular blur that is typically diagnosed via fundus and fluorescein angiographic appearance. The etiology and pathophysiology are not fully understood; however, there may be an association with an infectious etiology. This article presents two cases of HIV-positive patients in whom central serous chorioretinopathy developed and discusses the possible relationship between the two cases. The differential diagnosis, clinical features, angiographic appearance, management options, and proposed etiologies of CSC will be presented. CASE REPORTS: A 34-year-old black man HIV reported to the eye clinic with decreased vision in his right eye. A diagnosis of central serous chorioretinopathy (CSC) was made on the basis of the clinical and fluorescein appearance. He is currently being monitored for resolution. A 44-year-old black man with profoundly compromised immunity also came to the eye clinic with CSC and HIV retinopathy. He later progressed to CMV retinitis and subsequently died. CONCLUSION: Although considered in many cases to be idiopathic, central serous chorioretinopathy has been associated with infectious etiologies, one of which could be HIV.
Dinakaran, S. and S. P. Desai (1999). "Central serous retinopathy associated with Weber-Christian disease." Eur J Ophthalmol 9(2): 139-41.
PURPOSE: To report an association between central serous retinopathy and Weber-Christian disease. METHODS: A case report. RESULTS: Central serous retinopathy was noticed in a patient with Weber-Christian disease possibly secondary to vasculitis involving the choriocapillaris. CONCLUSIONS: Central serous retinopathy may be associated with an uncommon systemic condition like Weber-Christian disease.
Vingrys, A. J. and K. Pesudovs (1999). "Localized scotomata detected with temporal modulation perimetry in central serous chorioretinopathy." Aust N Z J Ophthalmol 27(2): 109-16.
AIM: Flicker deficits have been reported in various maculopathies, including age-related macular degeneration. We test whether flicker losses exist in patients with central serous chorioretinopathy (CSC) and whether the size and flicker frequency of the target is important in detecting such losses. METHODS: We examined four CSC patients with temporal modulation (flicker perception) perimetry using the Medmont auto-flicker module (Medmont Pty Ltd, Melbourne, Vic. Australia), as well as static perimetry and colour vision. One case was examined using sophisticated laboratory equipment to precisely measure their temporal contrast sensitivity function (temporal CSF or de Lange curve) using larger targets to consider the effect of target frequency and size. Two patients were followed longitudinally and tested after resolution of the maculopathy. We compared our patients with an age-matched control group of 11 people. RESULTS: Temporal modulation perimetry detected larger and more localized defects in all cases of active CSC compared with static perimetry. There appeared to be size and frequency tuning to the deficit, with greatest loss being found at 16 Hz with small (0.5 degree) targets. The losses resolved in one case where the retina recovered in 4 weeks, but remained to a lesser degree in another case who suffered a 2 year long fluctuating course before the CSC subsided. CONCLUSIONS: Temporal modulation perimetry detects a loss of flicker sensitivity in patients with CSC. Deeper and more clearly defined scotomata are found with a flickering stimulus compared with a steady state one. The greatest losses of flicker sensitivity are found with 16 Hz modulation and with small targets located directly over the lesion. The duration of the disease may be important for recovery of flicker sensitivity. Temporal modulation perimetry appears to be a valuable tool for the confirmation of functional loss due to CSC.
Iijima, H., T. Iida, et al. (1999). "Plasminogen activator inhibitor 1 in central serous chorioretinopathy." Am J Ophthalmol 127(4): 477-8.
PURPOSE: To describe the plasma level of plasminogen activator inhibitor 1, the major antifibrinolytic agent, in eyes with central serous chorioretinopathy, in which choroidal thrombosis is suspected as the underlying condition based on the findings of choroidal hyperpermeability in indocyanine green angiograms. METHODS: Plasminogen activator inhibitor 1 concentrations in the plasma of 17 patients with central serous chorioretinopathy were measured by enzyme-linked immunosorbent assay and compared with those in 12 age-matched normal volunteers. RESULTS: The plasma levels of plasminogen activator inhibitor 1 in patients with central serous chorioretinopathy (range, 25 to 439 ng/ml; median, 87 ng/ml) were significantly increased compared with those in normal volunteers (range, 7 to 84 ng/ml; median, 36 ng/ml) (P = .0013, Mann-Whitney U test). CONCLUSION: Increased plasminogen activator inhibitor 1 concentrations in patients with central serous chorioretinopathy support the hypothesis that the choroidal hyperpermeability disclosed by indocyanine green angiography is caused from impaired fibrinolysis and the resulting thrombotic occlusion in the choroidal veins.
Hussain, D. and J. D. Gass (1998). "Idiopathic central serous chorioretinopathy." Indian J Ophthalmol 46(3): 131-7.
Idiopathic central serous chorioretinopathy (ICSC) is usually seen in young males with Type A personality. Clinical evaluation of the macula with fundoscopy and biomicroscopy, coupled with fluorescein angiography establishes the diagnosis. Indocyanine green angiographic studies have reinformed that the basic pathology lies in choriocapillaries and retinal pigment epithelium. Most of the ICSC resolve completely in four months, and some of them could resolve early with direct photocoagulation of the leaking site. Oral steroids have no role, and could even cause an adverse reaction.
von Ruckmann, A., K. G. Schmidt, et al. (1999). "[Serous central chorioretinopathy. Acute autofluorescence of the pigment epithelium of the eye]." Ophthalmologe 96(1): 6-10.
PURPOSE: The lack of histopathological material has placed limitations on our knowledge on lipofuscin in central serous chorioretinopathy (CSCR). This study was designed to document the pathological changes of the retinal pigment epithelium (RPE) in CSCR using in vivo recording of fundus autofluorescence. METHODS: Fundus autofluorescence was documented in 62 eyes of 44 subjects with CSCR using a laser scanning ophthalmoscope (Zeiss, Oberkochen; excitation wavelength: 488 nm, barrier filter at 521 nm). Images were compared to the respective fundus appearance and fluorescein angiograms. RESULTS: Neurososensory retinal detachments showed diffuse increased autofluorescence corresponding to the detached area. Long-standing lesions showed very irregular autofluorescence with regions greater and less than the background levels of autofluorescence. CONCLUSION: Focal accumulation of autofluorescent material occurs at the level of the RPE in patients with CSCR, relating to variation in metabolic activity of the RPE. This technique may be useful in selecting patients for laser photocoagulation.
Marmor, M. F. and F. Tan (1999). "Central serous chorioretinopathy: bilateral multifocal electroretinographic abnormalities." Arch Ophthalmol 117(2): 184-8.
OBJECTIVES: To assess retinal function topographically in the posterior pole of affected and fellow eyes with central serous chorioretinopathy. PARTICIPANTS AND METHODS: Multifocal electroretinograms (MERGs) were recorded from 6 patient with active central serous chorioretinopathy and 5 normal control subjects. Two patients also had full-field conventional ERGs. The MERG responses were averaged in rings radiating out from the foveal center. RESULTS: All of the patients had central macular detachments in the affected eyes, while the fellow eyes were normal except for a few small retinal pigment epithelial abnormalities. The MERG was not only depressed in areas of detachment as expected, but was also reduced beyond the area of detachment in affected eyes and throughout the posterior pole of the fellow eyes. Full-field ERGs were normal. CONCLUSIONS: The MERG findings show that there is broad retinal functional disturbance in central serous chorioretinopathy involving both eyes and areas beyond the zone of detachment. These data strongly suggest that diffuse and possibly systemic pathologic conditions underlie this disease and that the leak itself may be a somewhat incidental event. The MERG may prove useful as a clinical marker for susceptibility to serous detachment.
Bouzas, E. A., P. Moret, et al. (1999). "Central serous chorioretinopathy complicating solar retinopathy treated with glucocorticoids." Graefes Arch Clin Exp Ophthalmol 237(2): 166-8.
BACKGROUND: Solar retinopathy and central serous chorio-retinopathy are two well-defined clinical entities which affect the macular area. Their association has never been described. The relation of central serous chorioretinopathy with the exposure to glucocorticoids has been recently suggested. CASE REPORT: Central serous chorioretinopathy developed in a patient who received corticosteroid therapy for solar retinopathy. CONCLUSION: This case report provides additional evidence that central serous chorioretinopathy may develop under the effect of glucocorticoids. Retinal damage resulting from a previous insult, such as solar retinopathy, may act as the permissive factor.
Fabianova, J., M. Porubska, et al. (1998). "[Central serous chorioretinopathy--a new model of etiopathogenesis]." Cesk Slov Oftalmol 54(6): 405-8.
Fabianova, J., M. Porubska, et al. (1998). "[Central serous chorioretinopathy--treatment with beta blockers]." Cesk Slov Oftalmol 54(6): 401-4.
The authors present an account on their first experience with treatment of central serous chorioretinopathy (CSCHR) by beta-blocking agents. In 21 patients with CSCHR Trimepranol (metipranololum) a beta non-selective blocker, 2 x 10 mg/day for two to three months was used. In 30 patients with CSCHR Vasocardin (Metoprololi tartas) was used i.e. a beta-1 selective blocking agent, 2 x 50 mg/day for two to three months. In all patients remission of the disease occurred, on average 4.5 to 4.8 weeks after the onset of treatment. During treatment of CSCHR by beta-blocking agents no significant difference was found in the action of beta selective and non-selective blockers regardless of the duration of the disease before onset of treatment and the number of relapses.
Horiguchi, M., Y. Ito, et al. (1998). "Extrafoveal photostress recovery test in glaucoma and idiopathic central serous chorioretinopathy." Br J Ophthalmol 82(9): 1007-12.
BACKGROUND/AIMS: A photostress recovery test was designed to differentiate macular diseases from optic nerve disorders, but recently an abnormal recovery time was reported in glaucoma. The purpose of this study was to search for the difference in abnormality of the photostress recovery test between glaucoma and idiopathic central serous chorioretinopathy (ICSC). METHODS: This study involved 21 normal subjects, 14 patients, with ICSC and 10 patients with primary open angle glaucoma (POAG). A scanning laser ophthalmoscope (SLO) was used with microperimetry for bleaching the test point and measuring the recovery of sensitivity. Photostress recovery time (SLO-PSRT) could be measured at extrafoveal points outside and inside the affected area. The initial sensitivity change and the time constant of recovery after bleaching were calculated by fitting an exponential equation to the data. RESULTS: In normal subjects, neither the initial sensitivity change nor the time constant were correlated with the location of the test point. In 14 patients with ICSC, the initial sensitivity change in the detached area was significantly smaller than that in the unaffected area which was not significantly different from that in the age matched normal subjects. The time constant in the detached area was significantly longer than that in the unaffected area, which was not significantly different from that in the normal subjects. In 10 patients with POAG, the initial sensitivity change inside and outside the scotoma was not significantly different from that of age matched normal subjects. The time constant inside the scotoma was significantly longer than that outside the scotoma, which was not significantly different from that of the age matched normal subjects. CONCLUSION: Both ICSC and POAG showed a prolonged time constant of recovery, but the initial sensitivity change was reduced only in ICSC. The difference in our results between ICSC and POAG may be caused by the difference of the retinal pathology. Further, the SLO-PSRT is very useful when the lesion is located outside the fovea.
Yang, C. M. and C. P. Lin (1998). "Bullous retinal detachment in a patient with central serous chorioretinopathy." J Formos Med Assoc 97(10): 711-4.
Bullous retinal detachment, a severe and atypical presentation of central serous chorioretinopathy (CSCR), may develop in association with the use of systemic steroids. A 42-year-old man presented with a 2-month history of poor visual acuity in his right eye. A tentative diagnosis of Harada's syndrome was made and the patient was treated with large doses of systemic corticosteroids for 1 month, without improvement. Fundus examination showed bullous detachment with shifting subretinal fluid in both eyes. Fluorescein angiography demonstrated multiple leaking points with pigment epithelium detachment in both eyes. A diagnosis of bilateral severe CSCR was made and systemic steroid therapy was withdrawn. Several sessions of argon laser photocoagulation to the areas of fluorescein leakage in both eyes and transscleral drainage of subretinal fluid in the right eye were performed. Two months later, the retinae became attached in both eyes. Visual acuity in the right eye was limited by submacular fibrosis, while the visual acuity of the left eye was not affected. In summary, this case should alert physicians to suspect CSCR in patients with exudative retinal detachment, as the use of steroids is usually not only unnecessary but can also be harmful.
Hooymans, J. M. (1998). "Fibrotic scar formation in central serous chorioretinopathy developed during systemic treatment with corticosteroids." Graefes Arch Clin Exp Ophthalmol 236(11): 876-9.
BACKGROUND: The purpose of the study is to demonstrate the development of subretinal fibrotic scar formation in central serous chorioretinopathy (CSCR) that developed during systemic corticosteroid treatment. METHODS: The clinical and photographic records of a patient in whom an unusual manifestation of severe central serous chorioretinopathy developed during systemic corticosteroid treatment were reviewed. RESULTS: A 34-year-old man received high dosages of corticosteroids for several years because of severe asthma. There was no previous history of idiopathic CSCR. He developed three successive attacks of CSCR. On the third occasion, an unusual variant of severe CSCR was observed which presented as a bullous sensory retinal detachment with subretinal serofibrinous exudate followed by subretinal fibrosis and fibrotic scar formation with contracting bands. After tapering of the corticosteroid dosage to a low level the retinal detachment resolved without laser treatment. CONCLUSION: The finding suggests that during systemic corticosteroid treatment atypical manifestations of CSCR may develop with subretinal fibrosis and scar formation.
Kao, L. Y. (1998). "Bilateral serous retinal detachment resembling central serous chorioretinopathy following epidural steroid injection." Retina 18(5): 479-81.
Sharma, O. P., N. Rao, et al. (1998). "Sarcoidosis and central serous retinopathy: a dangerous combination." Sarcoidosis Vasc Diffuse Lung Dis 15(2): 189-91.
Central serous retinopathy, a disorder of healthy young men, has also been reported to occur in patients with collagen vascular disease. This is the first report discussing the occurrence of central serous retinopathy in patients with sarcoidosis. It is critical to recognize the entity because corticosteroids, used in treating sarcoidosis, can have a disastrous effect on central serous retinopathy.
Sharma, S. (1998). "Ophthaproblem. Central serous chorioretinopathy." Can Fam Physician 44: 1827, 1833-5.
Gackle, H. C., G. E. Lang, et al. (1998). "[Central serous chorioretinopathy. Clinical, fluorescein angiography and demographic aspects]." Ophthalmologe 95(8): 529-33.
The purpose of this retrospective study was to analyze the demographic characteristics of central serous chorioretinopathy (CSC). METHODS: Findings of 100 consecutive subjects with CSC were evaluated. Clinical and fluorescein angiographic findings, demographic characteristics, and visual acuity were analyzed. RESULTS: The age of the patients ranged from 28 to 68 years with a mean of 43 years. No significant sex differences were found concerning age and other parameters. The highest age peak was in the group of women. The male to female ratio was 5:1. Patients with chronic CSC were significantly older (P = 0.015) than patients with the other angiographic findings. Median visual acuity was 0.5. In 40% bilateral characteristics of CSC were found. Clinical and fluorescein angiographic findings showed no significant correlation with visual acuity. CONCLUSION: The range of age distribution in CSC is wide. In older patients distinguishing CSC from age-related macular degeneration can be difficult.
Shiraki, K., M. Moriwaki, et al. (1997). "Long-term follow-up of severe central serous chorioretinopathy using indocyanine green angiography." Int Ophthalmol 21(5): 245-53.
BACKGROUND: The severe types of central serous chorioretinopathy (CSC) have a chronic nature, suggesting that a pathological process persists subclinically. Indocyanine green (ICG) angiography recently revealed intrachoroidal dye leakage and its static nature in CSC. As the intrachoroidal dye leakage was suspected to be relevant to the disease process, the long-term persistence of intrachoroidal ICG leakage was examined in four patients of the severe types of CSC. METHODS: ICG angiography was performed periodically over more than three years in three patients and two years in one patient. One patient had CSC with bullous retinal detachment, and the other three had chronic CSC or diffuse retinal pigment epitheliopathy. RESULTS: Intrachoroidal ICG leakage persisted in all the patients. However, a change in location of persistent intrachoroidal leakage or disappearance of intrachoroidal leakage regardless of no progression of retinal pigment epithelial alteration was noted in one eye of two patients. CONCLUSIONS: Pathology causing intrachoroidal ICG leakage persisted subclinically for a long period. However, location and extent of the intrachoroidal leakage could change during a long-term follow-up period.
Bartos, D., J. Kondrova, et al. (1998). "[Changes in psychovisual function after central serous chorioretinopathy]." Cesk Slov Oftalmol 54(3): 166-73.
Psychovisual examination methods detect macular changes better and more subtly then hitherto commonly used examination methods, in particular in dynamic investigations. The authors used this method in a series of investigations of diabetes, glaucoma and haemodialysis. The group is formed by 19 eyes of 16 patients with a first attack of central serous chorioretinopathy. Two thirds of the patients were treated by conservative methods, one third by photocoagulation with an argon laser. The observation period was 3 months to 13 years, the mean being 3.5 years. The control group was formed by a group of healthy subjects of corresponding age. The authors proved a statistically significant (5%) reduction of the contrast sensitivity at medium spatial frequencies (6 and 12 c/dg) in patients with one or several attacks of CSCHR. Statistically significant deterioration of colour discrimination (5%) was proved in patients with one attack of CSCHR in 20% of the patients. In patients with two or more attacks of the disease the authors recorded a statistically significant deterioration of colour discrimination (1%) in 44% of the patients. They did not reveal, using psychovisual examination methods, statistically significant differences between groups of patients treated conservatively or by laser. In all cases of impaired colour discrimination a disorder in the blue-yellow region was involved, i.e. in the region of retinal receptors.
Bernasconi, P., E. Messmer, et al. (1998). "Assessment of the sympatho-vagal interaction in central serous chorioretinopathy measured by power spectral analysis of heart rate variability." Graefes Arch Clin Exp Ophthalmol 236(8): 571-6.
BACKGROUND: The purpose of this study was to measure the activity of the sympathetic nervous system in patients with central serous chorioretinopathy (CSC) by power spectral analysis (PSA) of heart-rate (RR-interval) variability, a noninvasive method that reflects the balance of the sympathetic-vagal interaction. METHODS: The following four different groups of patients were measured; group 1, acute CSC (n = 11); group 2, acute recurrent CSC (n = 7); group 3, chronic persistent CSC (n = 4); group 4, complete remission of CSC (n = 9). The data recorded for these 31 patients (29 men and 2 women), with an average age of 44 years were compared with those noted for a group of 15 age-matched healthy individuals. The sympathetic-vagal balance is expressed by the ratio of the low-frequency component (LF) to the high-frequency component (HF) of the power spectrum. RESULTS: Significant differences in mean LF/HF ratios were found as follows for all but one of the sub-groups as compared with the normal controls (LF/HF = 1.1): group 1, LF/HF = 5.5 (P < 0.01); group 2, LF/HF = 5.4 (P < 0.05); group 3, LF/HF = 4.2 (P = 0.1); and group 4, LF/HF = 3.0 (P < 0.01). There was also a significant difference between active CSC and inactive CSC (P < 0.05). CONCLUSIONS: These results support the view that the pathogenesis of CSC is related to an increase in the sympathetic activity of the autonomic nervous system. Furthermore, the LF/HF ratios seem to correlate with the activity of the disease.
Remky, A., O. Arend, et al. (1998). "Infrared imaging of central serous chorioretinopathy: a follow-up study." Acta Ophthalmol Scand 76(3): 339-42.
BACKGROUND: Infrared (IR) imaging improved by using scanning laser ophthalmoscopy. The greater penetration of infrared light compared with visible wavelengths permits better visualization of subretinal structures such as drusen, hyperpigmentations and choroidal new vessels. Furthermore, using the indirect mode of the instrument to detect laterally scattered light, drusen and shallow detachments of the neuroretina can easily be visualized as prominent structures. In this study we investigated the potential use of non-invasive infrared imaging in follow-up examination of patients with central serous chorioretinopathy (CSCR). METHODS: All patients with an acute CSCR underwent fluorescein angiographic studies (488 nm) and infrared imaging (788 nm) in indirect mode using a scanning laser ophthalmoscope (SLO 101; Rodenstock) at baseline and follow-up after 3-5 weeks. RESULTS: The detachment of the neuroretina could easily be visualized by infrared imaging as prominent, oval-shaped structures. The height varied corresponding to the clinical course, whereas the extent showed no relation to the change in symptoms. CONCLUSION: IR-imaging is a quick, non-invasive tool which may efficiently be used in chorioretinal diseases. In CSCR patients it provides an adjunct in clinical follow-up by monitoring the course of the disease and the effect of treatment concepts.
Kapetanios, A. D., G. Donati, et al. (1998). "[Serous central chorioretinopathy and endogenous hypercortisolemia]." Klin Monatsbl Augenheilkd 212(5): 343-4.
BACKGROUND: The exact pathogenic mechanism of the accumulation of subretinal fluid at the posterior pole of the fundus in cases of central serous chorioretinopathy (CSC) is not well established. Recently, it was reported that CSC is more frequent among patients with endogenous Cushing's syndrome. Thus, it has been suggested that glucocorticoids might be involved in the pathogenesis of CSC. Subsequently, additional observations, have confirmed the relationship between glucocorticoids and CSC. We present preliminary data on the endogenous cortisol secretion in patients with CSC. PATIENTS AND METHOD: Sixteen patients (14 men and 2 women, 35-65 years of age) suffering from CSC, not exposed to exogenous glucocorticoids and without clinical and/or biological stigmata of endogenous Cushing's syndrome, have been examined. Twenty four hour urinary free cortisol (24 h-UFC) secretion was measured within one week of their CSC episode. Twenty four hour urinary free cortisol of age and sex matched controls were also measured. RESULTS: Twenty four hour urinary free cortisol was 188.20 nmol/l +/- 34.1 for the patients suffering from CSC and 115.3 nmol/l +/- 63.4 for the control group (p < 0.05). CONCLUSION: These results give additional evidence that glucocorticoids may play a role in the pathogenesis of CSC. However, given the substantial variability of urinary free cortisol levels, as indicated by the increased SD, additional number of patients should be examined.
Lafaut, B. A., C. Salati, et al. (1998). "Indocyanine green angiography is of value for the diagnosis of chronic central serous chorioretinopathy in elderly patients." Graefes Arch Clin Exp Ophthalmol 236(7): 513-21.
BACKGROUND: Central serous chorioretinopathy is characterized on indocyanine green angiography by areas of transient choroidal hyperfluorescence. These findings are thought to be the consequence of altered permeability of the choroidal vessels. METHODS: The indocyanine green angiograms of 41 patients between 40 and 60 years of age, with central serous chorioretinopathy and of 120 patients above 64 years of age with occult choroidal neovascularization due to age-related macular degeneration were reviewed for the presence of transient indocyanine green leakage. Twelve eyes of 9 patients above 64 years of age with (1) fluorescein leakage of undetermined source corresponding with well-delineated zone(s) of retinal pigmentary changes and (2) transient indocyanine green hyperfluorescence are reported in detail. RESULTS: Transient indocyanine green hyperfluorescence was seen in all eyes with central serous chorioretinopathy, either typical or chronic, and was seldom seen in occult choroidal neovascularization due to age-related macular degeneration. In the series of chronic serous chorioretinopathy in patients above 64 years of age, four classic choroidal neovascular membranes were found in 12 eyes. Most patients presented multizonal transient choroidal hyperfluorescence in both eyes on indocyanine green angiography. CONCLUSION: Transient choroidal hyperfluorescence is suggestive for chronic central serous chorioretinopathy in older patients presenting retinal pigmentary disease with fluorescein leakage of undetermined source. Chronic central serous chorioretinopathy is not uncommonly associated with classic choroidal neovascularization in the elderly.
Schmidt, D. (1998). "[Case presentation: Unmasking central serous chorioretinopathy]." Klin Monatsbl Augenheilkd 212(2): aA14.
Tilanus, M. A., A. J. Pinckers, et al. (1998). "Anomaloscope examination in macular gliosis, macular holes and central serous choroidopathy." Graefes Arch Clin Exp Ophthalmol 236(5): 326-32.
BACKGROUND: Surgery for macular gliosis and macular holes has become increasingly successful with regard to anatomical outcome. Assessment of the damage to the receptors by these processes is still difficult, but is important in predicting functional outcome. METHODS: Examination with the Nagel II or the Neitz OT anomaloscope was performed in 36 patients with macular gliosis, 23 patients with full-thickness macular holes and 47 patients with central serous choroidopathy. The anomaloscope matches were expressed as the quotient of anomaly. RESULTS: In macular gliosis the mid-matching point is usually 1.0; there is no pseudoprotanomaly. In macular holes the mid-matching point is 1.0 when visual acuity is 0.3 or greater; in eyes with lower visual acuity there may be signs of diminished red sensitivity, but anomaloscope examination becomes difficult. In central serous choroidopathy the mid-matching point is shifted towards red, and pseudoprotanomaly is present, even when visual acuity is normal. CONCLUSIONS: Diseases of the inner retina, in early stages, do not alter colour vision substantially, whereas diseases of the outer retina give rise to early colour vision deficiency. In macular gliosis and macular holes, anomaloscope examination enables estimation of macular receptor misalignment.
Park, D. W., H. Schatz, et al. (1998). "Central serous chorioretinopathy in two families." Eur J Ophthalmol 8(1): 42-7.
PURPOSE AND METHODS: The reported occurrence of central serous chorioretinopathy (CSCR) in families is rare. We report two families (five patients) who have been diagnosed with CSCR. The diagnosis of CSCR was made on clinical and fluorescein angiographic findings. RESULTS: Three members of the first family and two members of the second family had CSCR. Affected individuals were all males. CONCLUSIONS: CSCR has been associated with psychological and emotional stress and the occurrence of CSCR in families may be due to similar inherited psychological and physiological characteristics and responses that predispose these families to the development of CSCR.
Sharma, T., S. S. Badrinath, et al. (1998). "Subretinal fibrosis and nonrhegmatogenous retinal detachment associated with multifocal central serous chorioretinopathy." Retina 18(1): 23-9.
PURPOSE: To report the rare occurrence of subretinal fibrosis in patients with multifocal central serous chorioretinopathy and evaluate the role of systemic corticosteroids and the effects of laser photocoagulation on multifocal leaks. METHODS: A total of 29 patients (mean age, 37.7 years; 89.7% male) treated for subretinal fibrosis and multifocal central serous chorioretinopathy from 1983-1995 were reviewed retrospectively. Mean follow up was 26 months (range, 6.8-81 months). RESULTS: Retinal detachment involved the macula in 72.4% cases. Fluorescein angiography showed a mean of 6.7 (range, 2-22) central serous chorioretinopathy leaks and a mean of 1.8 (range, 1-5) retinal pigment epithelial detachments. The fundus pictures of 23 patients who were taking systemic corticosteroids showed no improvement. Following laser treatment, however, retinal reattachment was obtained in all eyes, and improvement in visual acuity of > 2 Snellen lines was noted in 68.9% of patients. CONCLUSIONS: The presence of subretinal fibrosis with secondary retinal detachment in otherwise healthy young patients, particularly in men, should alert the physician to look for multifocal central serous retinopathy leaks. Systemic corticosteroids did not prove effective in treating these patients, although laser treatment is recommended for each leak identified on an angiogram.
Garg, S. P., T. Dada, et al. (1997). "Endogenous cortisol profile in patients with central serous chorioretinopathy." Br J Ophthalmol 81(11): 962-4.
AIM: To study the endogenous cortisol levels in patients with central serous chorioretinopathy (CSCR). METHODS: Endogenous cortisol levels in urine and plasma were determined in 30 patients with acute CSCR and compared with 30 age and sex matched controls. RESULTS: The mean values of the 8 am plasma cortisol (29.97 micrograms/dl v 18.76 micrograms/dl), 11 pm plasma cortisol (22.03 micrograms/dl v 13.06 micrograms/dl), and 24 hour urine cortisol (11.01 mg/24 h v 7.39 mg/24 h) revealed significantly higher values in the patient group (p < 0.001). CONCLUSIONS: Increased levels of endogenous cortisol are present in patients with CSCR.
Marmor, M. (1997). "On the cause of serous detachments and acute central serous chorioretinopathy." Br J Ophthalmol 81(10): 812-3.
Menchini, U., G. Virgili, et al. (1997). "Indocyanine green angiography in central serous chorioretinopathy. ICG angiography in CSC." Int Ophthalmol 21(2): 57-69.
PURPOSE: To analyse images obtained by indocyanine green angiography in central serous chorioretinopathy (CSC). METHODS: Ninety patients affected with CSC were examined using indocyanine green angiography. RESULTS: CSC was detected in 127 of the 180 eyes examined. Leakage points were detected in 99 eyes with fluorescein angiography; in 85 of these eyes, they corresponded to hyperfluorescence with indocyanine green angiography, while a hyperfluorescence of the neuroepithelial detachment was seen in 21 eyes. Areas of choroidal hyperpermeability were seen in all 127 eyes with CSC and in 9 fellow eyes. With ICG angiography, the appearance of pigment epithelial detachments was similar to that previously described (early hyperfluorescence and later hypofluorescence), and was seen in 47 eyes. In 103 eyes, hypofluorescent lesions of various sizes, were detected which became more marked in the later stages. These lesions corresponded to retinal pigment epithelium lesions in fluorescein angiography, mainly hyperfluorescence caused by window defect. We were also able to observe RPE atrophic tracts in 31 eyes. These tracts appeared hyperfluorescent in 11 eyes where a minimal amount of RPE atrophy was present and hypofluorescent in 20 eyes in which the tract had marked RPE atrophy. CONCLUSION: The results obtained confirm the finding of choroidal hyperpermeability and subretinal diffusion of ICG, which indicate involvement of the choroid in CSC. The observation of progressively hypofluorescent lesions corresponding to retinal pigment epithelium alterations suggests that there may be as yet unknown interactions of pigment epithelium and ICG.
Beck, R. W. (1997). "Laser photocoagulation for central serous retinopathy." Ophthalmology 104(12): 1981-2.
Abu el-Asrar, A. M. (1997). "Central serous chorioretinopathy complicating systemic corticosteroid therapy." Eur J Ophthalmol 7(3): 297-300.
PURPOSE: To present evidence that systemic corticosteroid therapy may cause central serous chorioretinopathy. METHODS: A 20-year-old male with idiopathic thrombocytopenic purpura was examined during systemic treatment with corticosteroids (100 mg daily). RESULTS: The patient had central serous chorioretinopathy. Spontaneous recovery accompanied discontinuation of the steroid treatment. CONCLUSIONS: This case provides further evidence that cortisol may play a role in the development of central serous chorioretinopathy.
Lafaut, B. A. and J. J. De Laey (1996). "Indocyanine green angiography in central serous chorioretinopathy." Bull Soc Belge Ophtalmol 262: 55-61.
Five cases of various stages of central serous chorioretinopathy are presented. The indocyanine green angiographic characteristics of central serous chorioretinopathy are discussed. The value of this technique in recognizing central serous chorioretinopathy in older patients from genuine age related macular dystrophy will be indicated.
Haimovici, R., E. S. Gragoudas, et al. (1997). "Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids." Ophthalmology 104(10): 1653-60.
OBJECTIVE: The purpose of the study is to investigate the relationship between inhaled or intranasal adrenergic agonists and corticosteroids and the development of central serous chorioretinopathy (CSC). DESIGN: The medical records of three patients with CSC who were found to use inhaled adrenergic agents or corticosteroids or both were identified prospectively. A survey of members of the Retina, Macula, and Vitreous societies and the National Registry of Drug-Induced Ocular Side Effects identified three additional cases. RESULTS: Six patients with CSC were found to be chronic users of corticosteroid (four patients) or both beta adrenergic agonist and corticosteroid (two patients) metered dose inhalers or nasal sprays. In three cases, there was a close temporal correlation between the use of a corticosteroid nasal spray and the development of CSC. CONCLUSIONS: These findings suggest that, in patients who are susceptible, the periocular or systemic absorption of inhaled corticosteroids may be sufficient to produce CSC in humans, supporting previous hypotheses regarding the pathogenesis of the disorder. Further studies are needed to confirm this association and to determine whether inhaled adrenergic agents also contribute to the development of this disorder. Patients in whom CSC develops while using corticosteroid inhalers or nasal sprays should be alerted to the possible relationship between CSC and these agents.
Spraul, C. W., G. E. Lang, et al. (1997). "[Central serous chorioretinopathy in systemic therapy with corticosteroids]." Ophthalmologe 94(6): 392-6.
PURPOSE: To describe retinal pigment epithelial changes associated with systemic corticosteroid treatment. METHODS: We report on five patients who developed maculopathy during treatment with systemic corticosteroids. A thorough ophthalmologic examination including perimetry, fundus photography, and fluorescein angiography was performed. RESULTS: Three patients displayed focal and two patients showed diffuse retinal pigment epithelial changes comparable to the acute and chronic form of central serous chorioretinopathy, respectively. Four of five patients had a complete visual recovery after decrease or cessation of treatment with corticosteroids. CONCLUSION: These five patients provide further evidence that systemic treatment with corticosteroids may damage the posterior blood-retinal barrier, leading to central serous chorioretinopathy. Visual acuity may increase after reduction of the dosage or cessation of treatment with corticosteroids. Patients on systemic corticosteroid treatment should be informed about possible symptoms of central serous chorioretinopathy in order to prevent irreversible visual loss.
Khosla, P. K., S. S. Rana, et al. (1997). "Evaluation of visual function following argon laser photocoagulation in central serous retinopathy." Ophthalmic Surg Lasers 28(8): 693-7.
The authors of previous studies on the role of photocoagulation for central serous chorioretinopathy (CSR) have based their deductions on the premise that a Snellen visual acuity of 6/6 is the end point of recovery. It is now known that patients with a visual acuity of 6/6 may have defective contrast sensitivity indicative of a visual function deficit. The present study was a prospective, controlled, and randomized evaluation of patients suffering from their first attack of CSR, in which contrast sensitivity was used to determine the effectiveness of argon laser photocoagulation as compared with more conservative treatment. Although long-term studies are necessary, the results of this study showed that while photocoagulation increases the rate of recovery for visual acuity, it is also linked with significant loss and slower recovery of contrast sensitivity.
Zamir, E. (1997). "Central serous retinopathy associated with adrenocorticotrophic hormone therapy. A case report and a hypothesis." Graefes Arch Clin Exp Ophthalmol 235(6): 339-44.
BACKGROUND: Central serous retinopathy (CSR) has been linked by several authors to the therapeutic use of adrenocorticotrophic hormone (ACTH) or corticosteroids or to endogenous ACTH hypersecretion. Various pathogenic mechanisms have been suggested to explain this phenomenon; all relate to the steroids as the causative agents. CASE REPORT: A simultaneous, bilateral central serous retinopathy developed in a woman treated by intramuscular injections of a synthetic ACTH analog for arthritis. The condition resolved 2 months after stopping the use of this drug. DISCUSSION: Many investigators consider CSR to be either a disorder of the retinal pigment epithelium (RPE) ion-pump function or a result of choroidal vascular hyperpermeability. ACTH has a melanotrophic part, melanocyte-stimulating hormone (MSH), that may affect RPE cells, which are melanin-pigmented cells of neuroectoderm origin, and alter their ionic pumping properties. This is supported by evidence in the literature for the effect of MSH on animal RPE cells, as well as on other secreting epithelia. MSH is known to act through increasing intracellular cAMP levels. Based on the current concepts regarding the pathogenesis of CSR, two possible mechanisms for ACTH/MSH-associated CSR are suggested. In the first, MSH increases intracellular cAMP levels in RPE cells, thereby inducing pump dysfunction and a reversal of ionic current direction, leading to subretinal fluid accumulation. An alternative mechanism is based on the known ability of MSH to increase the permeability of blood-aqueous and blood-brain barriers. It is hypothesized that MSH disrupts the outer blood-retinal barrier or causes leakage from choroidal vessels.
Chen, M. S. and W. F. Tsai (1997). "Congenital optic pits and central serous chorioretinopathy." Aust N Z J Ophthalmol 25(2): 165-6.
PURPOSE: The reporting of the occurrence of central serous chorioretinopathy in a patient with congenital optic pits. METHODS: A 31-year-old man complained of blurred vision in the right eye for 1 week. He had a visual acuity of 20/25 in the right eye. He underwent ophthalmoscopy and fluorescein angiography. RESULTS: Ophthalmoscopy revealed serous detachment of macula with its margin not adjacent to the margin of optic disc. Fluorescein angiography showed a typical ink blot appearance of dye leakage. CONCLUSIONS: Central serous chorioretinopathy can occur in the patient with congenital optic pits. Detailed ophthalmoscopic and fluorescein angiographic studies are necessary to establish the diagnosis of optic pits associated with macular detachment. Various mechanisms have been reported to explain the serous macular detachment in patients with optic pits including vitreous and cerebrospinal fluid leakage through the optic pit and from there into the subretinal space. The present case further denotes that central serous chorioretinopathy in the presence of optic pits can be due to leakage from the retinal pigment epithelium.
Wakakura, M., E. Song, et al. (1997). "Corticosteroid-induced central serous chorioretinopathy." Jpn J Ophthalmol 41(3): 180-5.
Five patients were identified by medical records and fluorescein angiography as having developed central serous chorioretinopathy (CSC) during corticosteroid treatment. These five and 28 previously reported corticosteroid-induced CSC occurrences were studied to clarify the differences between idiopathic CSC and corticosteroid-induced CSC. Nine previously reported occurrences of corticosteroid-induced multiple posterior pigment epitheliopathy (MPPE) were also reviewed. Corticosteroid-induced CSC patients were older and less male-dominant; in MPPE, female patients predominated and most had bilateral involvement. The onset of CSC was within 70 days of corticosteroid administration in the short latency group, and more than 6 months after administration in the prolonged latency group. Daily doses of prednisolone usually exceeded 20 mg in the short latency group and was less than 20 mg in the prolonged latency group. Immunosuppressive agents such as cyclophosphamide were related to a lower daily dose at onset.
Burumcek, E., A. Mudun, et al. (1997). "Laser photocoagulation for persistent central serous retinopathy: results of long-term follow-up." Ophthalmology 104(4): 616-22.
PURPOSE: The authors evaluated the effect of laser photocoagulation for persistent central serous retinopathy (CSR). METHODS: The authors evaluated 45 eyes of 38 patients who had been offered laser photocoagulation for CSR that did not resolve after 4 months of observation. Sixteen eyes of 14 patients who did not accept laser photocoagulation were followed as the control group. The remaining 29 eyes of 24 patients comprised the study group. Argon green laser photocoagulation was performed on 9 eyes, dye-yellow laser photocoagulation was performed on 12 eyes, and dye-orange laser photocoagulation was performed on 8 eyes. Mean follow-up was 4.8 years (range, 1-7 years). RESULTS: In the group that received laser treatment, duration of the serous detachment was shorter (P < 0.0001) and final best-corrected visual acuity (BCVA) was better (P = 0.006) than those of the control group. Although none of the eyes in the laser photocoagulation group had a recurrence, seven eyes in the control group had one or more recurrences during the mean follow-up period of 4.8 years (P = 0.0003). Although the duration of the serous detachment was shorter in the dye-yellow laser photocoagulation subgroup than in the argon green laser treatment subgroup (P = 0.01), there were no other differences between the laser photocoagulation subgroups with respect to the duration of the serous detachments or the final BCVA. CONCLUSION: Direct laser photocoagulation of the leakage site(s) for CSR that persists for 4 months is safe and effective to shorten the duration of the serous detachment, to improve final BCVA, and to decrease the incidence of recurrence.
Song, E., M. Wakakura, et al. (1997). "[Central serous chorioretinopathy induced by corticosteroids]." Nippon Ganka Gakkai Zasshi 101(3): 257-64.
Five patients were diagnosed as having central serous chorioretinopathy (CSC) during systemic corticosteroid treatment based on medical records and fluorescein angiography. Twenty-eight previously reported corticosteroid-induced CSC cases in addition to these 5 were examined to clarify clinical differences between idiopathic CSC and corticosteroid-induced CSC. Nine previously reported cases of corticosteroid-induced multifocal posterior pigment epitheliopathy (MPPE) were also reviewed. The corticosteroid-induced CSC patients were older and less male-dominant. In MPPE, bilateral involvement was noted in most cases and females were dominant. We found two patient groups; in the short latency group, the onset of CSC occurred within 70 days of corticosteroid administration and in the prolonged latency group, more than 6 months after. The daily dose of prednisolone for the former usually exceeded 20 mg/day, in contrast to the latter, at less than 20 mg/day. Immunosuppressive drugs such as cyclophosphamide made it possible to diminish the onset daily dose.
Park, D. W., H. Schatz, et al. (1997). "Ring retinal pigment epithelial window defect of the macula in central serous chorioretinopathy." Retina 17(3): 205-10.
PURPOSE: Central serous chorioretinopathy is usually a benign disorder, in which resolution of serous subretinal fluid and return to a visual acuity of 20/40 or better is the normal outcome. In unusual cases of central serous chorioretinopathy, chronic subretinal fluid can lead to permanent retinal pigment epithelial depigmentation. In this report, we describe a ring-like (bull's eye) pattern of retinal pigment epithelial atrophy associated with central serous chorioretinopathy. METHODS: We examined eight patients (nine eyes) with central serous chorioretinopathy in whom retinal pigment epithelial window defects encircling the fovea developed. RESULTS: The average duration of symptoms before recognition of a circular window defect was 6 years. Visual acuity at the time of documentation of the ring-like window defect was 20/40 or worse in seven of nine (77%) eyes. Although laser photocoagulation treatment was performed in six of the nine eyes, vision improved two or more lines in only one eye (17%). CONCLUSION: Chronic central serous chorioretinopathy can cause a ring-like (bull's eye) pattern of retinal pigment epithelial window defects encircling the fovea. This pattern of retinal pigment epithelial window defect when seen in patients with central serous chorioretinopathy may indicate that a patient has a more severe form of central serous chorioretinopathy.
Okushiba, U. and M. Takeda (1997). "[Study of choroidal vascular lesions in central serous chorioretinopathy using indocyanine green angiography]." Nippon Ganka Gakkai Zasshi 101(1): 74-82.
We performed fluorescein and indocyanine green (ICG) angiographies in 56 patients with central serous chorioretinopathy, and studied the choroidal lesions. In the early phase, choroidal filling with ICG was delayed in 77% in the area including focal leakage. Hypofluorescent findings around the site of focal leakage persisted through the phase in 23%, and we think this finding was caused by filling defect of the choriocapillaris. In the late phase, choroidal tissue staining by ICG was present in 82% in the area including focal leakage. Multiple areas of choroidal staining were also present in unaffected areas in 43% and in 62% of fellow eyes. Choroidal tissue staining by ICG was revealed in 48% in the area of choroidal filling delay, and this finding persisted after focal leakage had disappeared following photocoagulation. We think this finding was caused by choroidal vascular hyperpermeability. These findings suggest that choroidal circulatory disturbance and choroidal vascular hyperpermeability play a causative role in damage to the retinal pigment epithelium in central serous chorioretinopathy.
(1996). "[Some aspects of research and development in diagnosis and treatment of central serous chorioretinopathy in Japan]." Nippon Ganka Gakkai Zasshi 100(12 Spec No): 32-41.
Cunningham, E. T., Jr., P. R. Alfred, et al. (1996). "Central serous chorioretinopathy in patients with systemic lupus erythematosus." Ophthalmology 103(12): 2081-90.
PURPOSE: To describe three patients with systemic lupus erythematosus in whom ophthalmoscopic and fluorescein angiographic evidence of central serous chorioretinopathy developed. METHODS: The authors retrospectively reviewed the clinical and photographic records of three patients with systemic lupus erythematous in whom central serous chorioretinopathy developed. RESULTS: Ophthalmoscopic changes observed in these patients with systemic lupus erythematosus included discrete areas of clumping and mottling of the retinal pigment epithelium (RPE), focal RPE detachments, serous elevations of the neurosensory retina, and late subretinal fibrosis with scar formation. Fluorescein angiographic findings included transmission hypofluorescence and hyperfluorescence corresponding to focal RPE alterations, early punctate intense hyperfluorescence corresponding to RPE leaks with progressive filling of sub-RPE detachment spaces, and slow late filing of subretinal detachment spaces. CONCLUSION: Patients with systemic lupus erythematosus are at increased risk to have central serous chorioretinopathy develop. The pathogenetic implications for an association between systemic lupus erythematosus and central serous chorioretinopathy as well as the similarity to the chorioretinopathy seen with accelerated hypertension, pregnancy, hemodialysis, organ transplantation, and exogenous and endogenous hypercortisolism are discussed. Focal choroidal vasculature compromise with secondary dysfunction of overlying RPE cells is the proposed common mechanism.
Spaide, R. F., L. Campeas, et al. (1996). "Central serous chorioretinopathy in younger and older adults." Ophthalmology 103(12): 2070-9; discussion 2079-80.
PURPOSE: The purpose of the study is to investigate the demographic characteristics and clinical findings of central serous chorioretinopathy (CSC). METHODS: This study examined a consecutive series of 130 patients with CSC seen over an 18-month period. RESULTS: The mean age of the patients when examined was 51 years, and the male-to-female ratio was 2.6:1.0. A total of 62 patients were older than 50 years of age when first examined. Although the patients shared some clinical and angiographic similarities, the older patients had a lower mean visual acuity and were more likely to have diffuse retinal pigment epitheliopathy, bilateral involvement, and secondary choroidal neovascularization than were the younger patients. With ophthalmoscopic and angiographic examination results, it was possible to differentiate CSC in older adults from choroidal neovascularization. CONCLUSION: This study expands the clinical concept of CSC. The male-to-female ratio was much lower, and the range of ages of the patients was much greater than in previous studies. Disease manifestations in older adults differed somewhat from those seen in younger adults. In older patients, CSC can be distinguished from other exudative maculopathies, particularly that of choroidal neovascularization secondary to age-related macular degeneration.
Weinberger, D., H. Stiebel, et al. (1996). "Three-dimensional measurements of central serous chorioretinopathy using a scanning laser tomograph." Am J Ophthalmol 122(6): 864-9.
PURPOSE: To evaluate the topographic three-dimensional mapping of retinal elevation in central serous chorioretinopathy using the Heidelberg Retina Tomograph and to correlate the measured parameters with the fluorescein angiographic findings. METHODS: Seventy-six consecutive patients with central serous chorioretinopathy (63 men, 13 women), between 26 and 54 years of age, were examined to identify areas of neurosensory retinal detachment and fluorescein leakage. In areas of retinal detachment, the parameters measured were the area, volume, maximal height, and diameters of the retinal elevation, which were statistically analyzed, and the correlations between these parameters were evaluated. RESULTS: Mean +/- SD area of elevation was 9.6 +/- 5.22 mm2 (range, 2.7 to 21.5 mm2); mean volume was 1.16 +/- 1.3 mm3 (range, 0.11 to 4.73 mm3); mean maximal height was 238 +/- 108 microns (range, 97 to 450 microns); mean x-axis was 3.4 +/- 1.1 mm (range, 1.6 to 5.6 mm); and mean y-axis was 3.03 +/- 0.98 mm (range, 1.6 to 4.7 mm). Most of the retinal elevations were oval (the x-axis longer than the y-axis); the maximal height was in the geometric center in the smaller blebs and below the geometric center in the larger blebs. There were statistically significant correlations between area, volume, and height of the sensory elevation. No correlation was found between the location and the shape of leakage on fluorescein angiography and the Heidelberg Retina Tomograph measurements. CONCLUSIONS: Confocal laser tomography is potentially useful as a noninvasive diagnostic technique for quantitative measurements of the neurosensory retinal detachment in central serous chorioretinopathy.
Yap, E. Y. and D. M. Robertson (1996). "The long-term outcome of central serous chorioretinopathy." Arch Ophthalmol 114(6): 689-92.
OBJECTIVE: To assess the long-term outcome of central serous chorioretinopathy (CSR) among a group of patients who previously participated in a prospective argon laser photocoagulation study of CSR. DESIGN: Thirty-eight of 41 surviving patients with CSR participating in an earlier study were invited to participate in a follow-up study that included history taking, ophthalmoscopy, biomicroscopy, and fundus photography. RESULTS: Thirty-seven (38 eyes) of 38 surviving patients (97%) were available for follow-up between 11 and 15 years after participation in the earlier study. There were no clinically documented or historical recurrences of CSR among the six eyes previously treated by direct laser photocoagulation. There were 13 clinically documented recurrences and four historical recurrences among the 32 eyes not treated with direct laser photocoagulation. The difference in recurrences was statistically significant (P = .02). Pigment changes indistinguishable from age-related macular degeneration frequently occurred in eyes with CSR. The difference in the development of such pigment changes between eyes with CSR (33 of 38) and nonaffected fellow eyes (12 of 35) was significant (P = .001). CONCLUSIONS: The decreased rate of CSR recurrence after direct laser photocoagulation reported in an earlier study was sustained with follow-up beyond 10 years. Pigmentary changes in the fundus indistinguishable from those associated with age-related macular degeneration developed in eyes affected with CSR, probably as a consequence of the presence of subretinal fluid accompanying the CSR rather than from early age-related macular degeneration.
Oosterhuis, J. A. (1996). "Familial central serous retinopathy." Graefes Arch Clin Exp Ophthalmol 234(5): 337-41.
PURPOSE: To study the familial occurrence of central serous retinopathy (CSR). METHODS: We pooled data from eight eye clinics in Western Europe. RESULTS: We collected 11 families that each had two to four members with CSR. In 10 families siblings and in one family a mother and son were affected. Sixty percent of the patients were male and 40% female. CSR was found in 55 (92%) of 60 eyes, 44 (80%) showing a chronic course. In 25 patients (83%) both eyes were affected. Most recent visual acuity was 0.5 or less in 17 (39%) and 0.2 or less in 8 (18%) of the eyes with chronic CSR. CONCLUSION: Our findings of familial occurrence and a chronic disorder that is progressive, diffuse, and bilateral suggest an inborn disposition to develop a clinically manifest disintegration of the retinal pigment epithelium in adulthood.
Balo, K. P. and H. Mihluedo (1996). "[Idiopathic central serous chorioretinopathy: two case reports observed in Togo]." Med Trop (Mars) 56(4): 381-3.
Central serous chorioretinopathy is due to accumulation of serous fluid between the sensory retina and pigmented epithelium. Our perusal of the literature did not turn up any reports on this topic in Black Africa. The disorder was observed in 2 patients from Togo who presented with unilateral reduction in visual acuity. Initially suspected by the presence of a macular lesion on the fundus and by ophthalmoscopic examination, diagnosis was confirmed by angiofluorography. Angiofluorography is the method of choice and the low incidence of this eye disorder in Black Africa is probably due to the poor availability of this method. Although the two patients in this study responded to corticosteroid therapy, treatment usually requires laser photocoagulation to eliminate the site of abnormal transudation and create a choroidal adhesion. In this regard recent studies indicate that the primary mechanism underlying this disorder is multifocal or diffuse hyperpermeability of the choroidal vessels.
Mathews, D. E. (1996). "Clinical grand rounds. Idiopathic central serous chorioretinopathy." Optom Clin 5(1): 175-84.
Idiopathic central serous chorioretinopathy is a very commonly seen disease process involving atypical RPE cells allowing the development of a neuroepithelial retinal detachment. Typically, this disease is self-contained and resolves spontaneously; however, on occasion, one must intervene by treating the area of atypical RPE with laser photocoagulation. Patients with ICSC should be monitored closely for any signs of choroidal neovascular membrane.
Spaide, R. F., L. Hall, et al. (1996). "Indocyanine green videoangiography of older patients with central serous chorioretinopathy." Retina 16(3): 203-13.
PURPOSE: The authors studied the indocyanine green (ICG) videoangiography findings of central serous chorioretinopathy (CSC) in older adults. BACKGROUND: Central serous chorioretinopathy in older adults may be confused with the exudative forms of age-related macular degeneration (AMD) because the two entities may have similar ophthalmoscopic and fluorescein angiographic findings. Because of its enhanced ability to image the choroidal circulation, ICG videoangiography has been used to describe certain choroidal vascular abnormalities in young adults with CSC, as well as older patients with choroidal neovascularization (CNV). The ICG videoangiography findings in CSC in older adults is largely unknown. METHODS: The authors performed ICG videoangiography on 36 patients aged 50 years or older with CSC to characterize their findings. RESULTS: The ICG videoangiography findings of the patients were consistent, revealing choroidal vascular hyperpermeability manifested by areas of hyperfluorescence that were first seen in the midphase of the angiogram. In the later phases of the angiogram, there were dispersion of the hyperfluorescence and a distinctive silhouetting of the larger choroidal vessels. CONCLUSIONS: Older patients with CSC have a unique temporal and topographic pattern of hyperpermeability that can help establish the proper diagnosis.
Khairallah, M., F. Nouira, et al. (1996). "[Central serous chorioretinopathy in a pregnant woman]." J Fr Ophtalmol 19(3): 216-21.
PURPOSE: A case of central serous chorioretinopathy in a 28-year-old pregnant woman is reported. METHODS: A complete ocular examination was performed including fundus biomicrospic examination and fluorescein angiography. RESULTS: Examination of the left eye revealed central serous chorioretinopathy associated with greyish-white subretinal exudate. In the right eye, sequaele of asymptomatic central serous chorioretinopathy was found. Reattachment of the retina and dissolution of the exudate, with return of visual acuity to normal, occurred soon after delivery. CONCLUSION: This case report is the 19th case of central serous chorioretinopathy during pregnancy reported to date. Central serous chorioretinopathy in pregnant woman is often associated with subretinal exudation which is probably fibrinous in nature. The affection resolves spontaneously at the end of pregnancy or after delivery, but may recur in the context or outside of subsequent pregnancy. The special conditions of pregnancy, including haemodynamic, biological and psychological alterations may lead susceptible women to develop central serous chorioretinopathy.
Quillen, D. A., D. M. Gass, et al. (1996). "Central serous chorioretinopathy in women." Ophthalmology 103(1): 72-9.
BACKGROUND: Central serous chorioretinopathy is a disorder that typically affects young and middle-aged men. Although extensive information is available pertaining to the clinical features of central serous chorioretinopathy in men, little is known about this condition in women. MATERIALS AND METHODS: The authors reviewed the medical records and photographic files of women who received a diagnosis of central serous chorioretinopathy. The women were divided into three groups for data analysis: idiopathic, exogenous corticosteroid use, and pregnancy. RESULTS: Fifty-one women with active central serous chorioretinopathy were evaluated. These findings in women with idiopathic serous chorioretinopathy were similar to those described in men, with the exception that women tend to be older at the time of onset. Central serous chorioretinopathy in women taking exogenous corticosteroids more likely was characterized by bilateral involvement and subretinal fibrin. Central serous chorioretinopathy in pregnant women typically developed in the third trimester and resolved spontaneously within 1-2 months after delivery. CONCLUSION: Idiopathic central serous chorioretinopathy is similar in women and men, with the exception that women tend to be more older at the time of onset. The finding of exogenous corticosteroid use in a significant number of women in our study provides further support that cortisol may play a role in the development of central serous chorioretinopathy. The mechanism by which cortisol influences the development of central serous chorioretinopathy is unclear.
Prunte, C. and J. Flammer (1996). "Choroidal capillary and venous congestion in central serous chorioretinopathy." Am J Ophthalmol 121(1): 26-34.
PURPOSE: Abnormalities in choroidal perfusion have been hypothesized to be causative factors in central serous chorioretinopathy. This prospective study was performed to evaluate changes in the choroidal circulation in cases of central serous chorioretinopathy. METHODS: In 32 consecutive patients with acute or chronic recurrent central serous chorioretinopathy, complete clinical ophthalmologic examinations, fluorescein angiography, and indocyanine green angiography with a scanning laser ophthalmoscope and a digital imaging system were performed. RESULTS: All patients with acute and chronic recurrent central serous chorioretinopathy demonstrated a localized delay in arterial filling followed by choroidal hyperperfusion in the area of the damaged retinal pigment epithelium, frequently associated with dilated capillaries and dilated draining venules in one or more choroidal lobules. These changes corresponded to areas with pigment epithelial detachment or focal leakage from the retinal pigment epithelium found in fluorescein angiography. Furthermore, in some patients, localized choroidal ischemia could be observed in additional areas throughout the central fundus in both diseased eyes and normal fellow eyes. CONCLUSIONS: Delayed arterial filling followed by capillary and venous hyperemia, angiographically appearing as capillary and venous congestion, can be observed frequently in eyes with central serous chorioretinopathy. The results suggested that capillary or venous congestion after ischemia in one or more choroidal lobules might be the reason for the choroidal hyperpermeability associated with central serous chorioretinopathy.
Kondrova, J. (1995). "[Central serous chorioretinopathy]." Cesk Slov Oftalmol 51(5): 304-9.
Makabe, R. and H. Gumbel (1995). "[Central serous chorioretinitis. Therapy experience over 20 years with and without laser coagulation]." Ophthalmologe 92(5): 654-6.
Since 1969, 1,179 eyes with central serous chorioretinopathy have been examined with fluorescein fundus angiography. The classic form with fluorescein leakage (type I) decreased in incidence from 86.4% to 55.4%, while an atypical form with frequent serous pigment epithelial detachment (type II) increased from 12.6% to 33.0%, and the mixed form (type I + II) increased from 1 to 11.6%. In type I with delayed healing laser coagulation of the leakage was performed, which improved the visual acuity from 0.64 to 0.92 an average (n = 122), while in cases without laser coagulation the percentage improved only from 0.66 to 0.84 on average (n = 34) with a statistically significant difference (t = 2.64, P < 0.01). Laser coagulation was especially beneficial in the mixed form (n = 16), in which the visual acuity improved from 0.42 to 0.86 on average. The proportion of women increased from 10.7 to 17.9%. The patient age tended to be higher in women more than in men.
Toonen, F., A. Remky, et al. (1995). "Microperimetry in patients with central serous retinopathy." Ger J Ophthalmol 4(5): 311-4.
In patients with acute central serous retinopathy (CSR), evaluation of visual acuity alone may not represent visual function. In patients with acute CSR, visual function may be disturbed by localized scotomas, distortion, and waviness. For the assessment of localized light sensitivity and stability of fixation, patients with CSR were evaluated by fundus perimetry with a scanning laser ophthalmoscope (SLO 101, Rodenstock Instruments). In all, 21 patients with acute CSR and 19 healthy volunteers were included in the study. Diagnosis of CSR was established by ophthalmoscopy and digital video fluorescein angiography. All patients and volunteers underwent static suprathreshold perimetry with the SLO. Light sensitivity was quantified by presenting stimuli with different light intensities (intensity, 0-27.9 dB above background; size, Goldmann III; wavelength, 633 nm) using an automatic staircase strategy. Stimuli were presented with simultaneous real-time monitoring of the retina. Fixation stability was quantified by measuring the area encompassing 75% of all points of fixation. Light sensitivity was 18-20 dB in affected areas, whereas in healthy eyes and outside the affected area, values of 22-24 dB were obtained. Fixation stability was significantly decreased in the affected eye as compared with normal eyes (33 +/- 12 versus 21 +/- 4 min of arc; P < 0.01). Static perimetry with an SLO is a useful technique for the assessment of localized light sensitivity and fixation stability in patients with macular disease. This technique could provide helpful information in the management of CSR.
Schatz, H., H. R. McDonald, et al. (1995). "Subretinal fibrosis in central serous chorioretinopathy." Ophthalmology 102(7): 1077-88.
PURPOSE: To report unusual and heretofore unreported visually damaging manifestations of severe central serous chorioretinopathy. METHODS: Case studies. RESULTS: Each of six male patients (average age, 40 years) had a form of severe central serous chorioretinopathy with at least one eye containing fibrin in the subretinal space that then developed into a subretinal fibrotic scar. Scar formation was followed by a tenting up of the macula, vascularization of the fibrosis (subretinal neovascularization), or a retinal pigment epithelial rip. Four of the seven eyes with subretinal fibrosis had severe visual loss (20/400 or worse). CONCLUSION: Subretinal fibrin and other extracellular matrix molecules appear to stimulate the retinal pigment epithelium to undergo fibrous metaplasia, which results in subretinal fibrotic scar formation and other sequelae, all of which can lead to severe visual loss.
Hee, M. R., C. A. Puliafito, et al. (1995). "Optical coherence tomography of central serous chorioretinopathy." Am J Ophthalmol 120(1): 65-74.
PURPOSE: To assess the potential of a new imaging technique, optical coherence tomography, for the diagnosis and monitoring of central serous chorioretinopathy. Optical coherence tomography is a novel noninvasive, noncontact imaging modality that produces high longitudinal resolution, cross-sectional tomographs of ocular tissue. METHODS: Optical coherence tomography is analogous to ultrasound, except that it uses light rather than sound to obtain higher image resolution in the retina. Cross-sectional tomographs of optical reflectivity within the retina are produced with longitudinal resolution of 10 microns. Optical coherence tomography was used to examine 16 patients at a referral eye center whose initial examination disclosed the clinical diagnosis of central serous chorioretinopathy. The optical coherence tomography results were correlated with slit-lamp biomicroscopy, fundus photography, and fluorescein angiography. RESULTS: The cross-sectional view produced by optical coherence tomography was effective in objectively quantifying the amount of serous retinal detachment in the disease. Optical coherence tomography disclosed detachments that were undetected by slit-lamp biomicroscopy. Longitudinal measurements with optical coherence tomography were successfully able to track the resolution of subretinal fluid accumulation. CONCLUSION: Optical coherence tomography is potentially useful as a new, noninvasive diagnostic technique for quantitative examination of patients with central serous chorioretinopathy and objectively monitoring the clinical course of the serous retinal detachment in this disease.
Remky, A., O. Arend, et al. (1995). "Digital imaging of central serous retinopathy using infrared illumination." Ger J Ophthalmol 4(4): 203-6.
When used with an infrared laser, scanning laser technology allows imaging of subretinal structures. In the indirect mode (scattered light), drusen, subretinal edema, and other changes in the retinal pigment epithelial complex can easily be visualized as pseudoprominent structures. This study was undertaken to determine the role of infrared imaging in central serous retinopathy. A total of 22 patients affected by acute central serous retinopathy were recruited for the study. All patients underwent fluorescein angiography (488 nm) and infrared imaging (788 nm) using a scanning laser ophthalmoscope (SLO 101; Rodenstock). The confocal mode was used for the fluorescein angiography, but the indirect mode was applied for infrared imaging. In all patients, serous detachment could be visualized by infrared imaging as pseudoprominent, oval-shaped structures. The size was at least one disk diameter and correspondend very well to the clinical appearance. In all patients, late-phase (20 min) fluorescein studies revealed the typical focal leakage with progressive hyperfluorescence. In six patients (27%) the extent of the serous detachment could be seen in a slightly hyperfluorescent rim. Digital image analysis showed that the extent of the serous detachment in the fluorescein angiogram was similar to the size of the thickened structures in the infrared image (r2 = 0.94). This initial study suggests that noninvasive infrared imaging can be a very useful indicator of serous detachment. Further studies regarding the influence of medical or laser treatment must be carried out to prove the clinical relevance.
Peyman, G. A. (1995). "Choroidal hyperpermeability in central serous choroidopathy: a new concept?" Arch Ophthalmol 113(6): 701-2.
Gass, J. D. and H. Little (1995). "Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy." Ophthalmology 102(5): 737-47.
PURPOSE: To present evidence that systemic corticosteroid therapy may cause bilateral bullous serofibrinous exudative retinal detachment in some patients with idiopathic central serous chorioretinopathy. BACKGROUND: Idiopathic central serous chorioretinopathy usually causes mild, transient loss of central vision, usually in otherwise healthy men with a type A personality. A few patients have permanent visual loss because of chronic and recurrent retinal detachment. The clinical findings in these patients may lead to incorrect diagnoses and use of corticosteroid therapy. METHODS: The clinical and photographic records of three patients in whom bilateral bullous serofibrinous exudative retinal detachment associated with idiopathic central serous chorioretinopathy developed after treatment with systemic corticosteroids were reviewed. RESULTS: Systemic corticosteroid treatment was instituted (1) as a prophylaxis to prevent exacerbation of the disease while undergoing surgery in the fellow eye, and (2) as the result of misdiagnoses of multifocal choroiditis and retinal vasculitis (Eales disease). Two of the patients had a history of chronic recurrent retinal detachments before institution of corticosteroid treatment. In one of these patients, bilateral chronic inferior retinal detachment developed, causing peripheral retinal vascular nonperfusion, retinal neovascularization, and vitreous hemorrhage. All three patients had severe permanent visual loss in one or both eyes. CONCLUSION: The findings in these patients provide further evidence that systemic corticosteroid treatment may cause severe exacerbation of retinal detachment and lasting visual loss in some patients with idiopathic central serous retinopathy. Recognition of the atypical presentations of this disorder is important to avoid incorrect diagnoses and treatment.
Matsunaga, H., K. Nangoh, et al. (1995). "[Occurrence of choroidal neovascularization following photocoagulation treatment for central serous retinopathy]." Nippon Ganka Gakkai Zasshi 99(4): 460-8.
Occurrence of choroidal neovascularization following laser photocoagulation treatment for central serous retinopathy (CSR) has been reported. We reviewed all the cases of photocoagulation treatment for CSR in our clinic during the past 25 years (1968-1993). Among 1,824 CSR-affected eyes which were treated, choroidal neovascularization occurred in 19 at the site of photocoagulation. In a careful reevaluation of pretreatment fluorescein angiograms, small choroidal neovascularizations were detected in 5 eyes, in which cases the diagnosis of CSR was incorrect. In 3 eyes, choroidal neovascularization was suspected and might have been masked. In the remaining 11 eyes, choroidal neovascularization was not seen. Our survey indicates that, in central serous retinopathy, when the age of the patient is over 50 years, and leakage is weak and parafoveal, choroidal neovascularization may be masked. Laser photocoagulation for these eyes should be conservative with careful, long-term observation.
Gupta, L. Y. and M. F. Marmor (1995). "Electrophysiology of the retinal pigment epithelium in central serous chorioretinopathy." Doc Ophthalmol 91(2): 101-7.
The pathophysiology of central serous chorioretinopathy is incompletely understood but appears to involve the retinal pigment epithelium. We recorded consecutively the fast oscillation, hyperosmolarity response, acetazolamide response, and light peak from four patients with active central serous chorioretinopathy and three normal subjects to determine whether the affected eyes showed any electrophysical abnormalities. We found essentially no differences in any of the four responses between the active and the inactive eyes of the patients or between patients and normal subjects. Whatever retinal pigment epithelial dysfunction exists in central serous chorioretinopathy is unassociated with clinically evident changes in these retinal pigment epithelial electrophysiologic responses.
Prunte, C. (1995). "Indocyanine green angiographic findings in central serous chorioretinopathy." Int Ophthalmol 19(2): 77-82.
There has been great controversy about the pathogenesis of the focal changes in the retinal pigment epithelium (RPE) causing detachment of the neurosensory retina in central serous chorioretinopathy (CSC). This study was performed to evaluate changes in choroidal perfusion in 15 patients with CSC. Fluorescein and indocyanine green (ICG) angiography was performed in patients with acute or chronic recurrent CSC. In all patients delayed arterial filling followed by capillary and/or venous congestion, in some cases adjacent to ischemic areas, was found in the choroid. Leakage from the RPE in fluorescein angiography was only observed in those areas with choroidal capillary and/or venous congestion. The preliminary results suggest that venous congestion possibly in association with ischemia causes hyperpermeability of choroidal vessels already described in the literature.
(1995). "[Treatment of central serous chorioretinopathy]." J Fr Ophtalmol 18(1): 64-5.
Piccolino, F. C., L. Borgia, et al. (1995). "Indocyanine green angiographic findings in central serous chorioretinopathy." Eye 9 ( Pt 3): 324-32.
The purpose of this study is to better characterise, on the basis of a large number of cases and follow-up evaluations, choroidal abnormalities recently observed with indocyanine green (ICG) angiography in central serous chorioretinopathy (CSC). Digital ICG videoangiography was performed in 145 patients with active or inactive, acute or chronic CSC. Forty-eight patients were re-examined in a follow-up period of 6-22 months (mean 10 months). Areas of choroidal leakage attributable to hyperpermeability of the choriocapillaris were found in 98.6% of patients in association with active or resolved pigment epithelial leaks and pigment epithelial detachments. Diffusion of ICG into the choroid was characterised by rapid centrifugal spreading of the dye with a wash-out pattern which was particularly evident in areas corresponding to pigment epithelial detachments. In patients with a long-standing disease, when choroidal hyperfluorescence faded, hypofluorescent spots became increasingly evident revealing pigment epithelial alterations not shown by fluorescein angiography. Areas of choroidal leakage remained unchanged in each patient during the follow-up period, even when subretinal exudation resolved either spontaneously or after photocoagulation. In 5 eyes we observed the appearance of leakage points on pre-existing areas of choroidal leakage. Zonal hyperpermeability of the choriocapillaris characterises all the evolutional stages of CSC and seems to be the primary alteration of this disease. When it corresponds to pigment epithelial detachments choriocapillaris hypermeability is probably associated with local hyperperfusion.
Scheider, A., C. Hintschich, et al. (1994). "[Central serous chorioretinopathy. Studies of the site of the lesion with indocyanine green]." Ophthalmologe 91(6): 745-51.
Indocyanine green angiographies of 33 patients with central serous chorioretinopathy (CSC) were examined in order to find out whether the location of ICG exudation was correlated with other findings. Areas of delayed choroidal filling at the site of the hot spot were found in 27 patients (82%). The hot spot was usually located at the margin of such areas. Furthermore, it seemed correlated to a larger ciliary artery in 19 patients (60.6%). A detachment of the pigment epithelium was detected in 18% and showed a characteristic early hypo- and late hyperfluorescence. There is evidence that the exudation of indocyanine green indicates a primary choroidal disorder as the cause of CSC. Many clinical features, for example pigment epithelial detachments, are easier to explain with this hypothesis. A correlation of the hot spot with variation of choroidal filling has to be interpreted with caution. Yet, it seems feasible that the border between areas of different speed of filling is especially vulnerable and might therefore decompensate in the case of diseased regulation of the choroidal vessels, as has been postulated for CSC.
Buhl, M., O. Liesenhoff, et al. (1994). "[Pathogenesis and therapy of central serous retinopathy]." Ophthalmologe 91(6): 741-4.
There is no consensus in the literature on the etiology and therapy of central serous retinopathy. We conducted a retrospective study to find out whether patients treated with argon laser coagulation (ALK) experienced long-term visual acuity improvement. We were also concerned to find whether choroidal perfusion was involved in the etiology. PATIENTS: In all, 28 patients (4 women/24 men) with RCS confirmed by angiography were analyzed. All patients were followed up from 1988 to 1992. Patients with chronic recurrent RCS were not considered. Angiography was performed to examine the type and localization of the leakage and also the choroidal perfusion. Patients who were treated with ALK were compared with patients who were not. RESULTS: Only 9 patients were treated with carefully directed ALK. Their mean visual acuity was 0.5 (STD 0.09) before therapy. After treatment the mean visual acuity was improved to an average of 0.8 (0.23). The follow-up time was up to 56 weeks. The patients without ALK had an initial visual acuity of 0.6 (0.21) which improved to 0.8 (0.22) during an observation period of 60 weeks. By the end of the study the visual acuity was the same in both groups. In 46% of all patients delayed choroidal perfusion was seen on angiography. CONCLUSION: There was no difference in visual acuity between patients treated with and without ALK. The angiographic examinations suggest general changes in choroidal perfusion in patients with RCS.
Jin, C., R. Gao, et al. (1994). "[Argon laser photocoagulation in the treatment of central serous chorioretinopathy]." Yan Ke Xue Bao 10(4): 227-31.
Thirty-six cases (41 eyes) with central serous chorioretinopathy were treated by using argon laser photocoagulation. The results showed that the number of eyes with vision equal to or more than 1.0 increased from 7 (17.1%) pre-laser to 26 (63.4%) post-laser, while the number of eyes with vision less than 1.0 decreased from 25 (61%) pre-laser to 6 (14.6%) post-laser. The subretinal fluid was almost entirely absorbed from 1 week to 1 month after, and central fovea reflex could be seen in some cases. The results indicate that the vision prognosis is strongly related to the duration of the disease, but the direction of leakage to the fovea, the distance between the leakage and the fovea, and the dimension of sensory retina detachment are factors which weakly affect the post-laser vision.
Guyer, D. R., L. A. Yannuzzi, et al. (1994). "Digital indocyanine green videoangiography of central serous chorioretinopathy." Arch Ophthalmol 112(8): 1057-62.
BACKGROUND: The pathogenesis of central serous chorioretinopathy (CSC) is poorly understood. Abnormalities in the choroidal circulation have been hypothesized to be causative factors. Fluorescein angiography has not been particularly useful in identifying specific choroidal defects in CSC, largely because of inherent limitations in imaging with this technique. Recent technologic advances in digital indocyanine green videoangiography allow enhanced imaging of the choroid and other subretinal structures in comparison with fluorescein angiography. METHODS: We performed digital indocyanine green videoangiography in 29 consecutive eyes with CSC and compared our results with clinical and fluorescein angiographic findings. RESULTS: Several newly recognized subretinal abnormalities in CSC were noted with digital indocyanine green videoangiography, including (1) presumed hyperpermeability of the choroidal circulation surrounding active retinal pigment epithelial leaks, (2) additional focal and multifocal areas of presumed choroidal hyperpermeability not associated with abnormalities detectable by fluorescein angiography or clinical examination, and (3) multiple presumed "occult" serous retinal pigment epithelial detachments with a characteristic indocyanine green videoangiographic pattern. CONCLUSION: We suggest that the pathogenesis of CSC may be due to a choroidal vascular hyperpermeability with and without associated active pigment epithelial leaks and multiple presumed "occult" serous retinal pigment epithelial detachments. Based on these findings, a hypothetical model can be constructed related to the pathogenesis of CSC, beginning with choroidal abnormalities that secondarily affect the retinal pigment epithelium and neurosensory retina.
Koskela, P., L. Laatikainen, et al. (1994). "Contrast sensitivity after resolution of central serous retinopathy." Graefes Arch Clin Exp Ophthalmol 232(8): 473-6.
The contrast sensitivity of 21 patients was measured using TV equipment (Wavetek 143 function generator and Sony PVM-90CE video monitor) and the Vistech test 6-15 years after the acute stage of central serous retinopathy. In the majority of cases contrast sensitivity was lower in the affected eye. The difference between the affected and the fellow eye was statistically significant at 1 and 6 cycles/degree (c/d) but not at 19 c/d. In 13/21 cases (62%) the results of the Vistech test were consistent with those of the TV test. Contrast sensitivity did not correlate with the duration of the disease or with the ultimate clinical picture of the macula. At 6 c/d there was a statistically significant correlation between visual acuity and contrast sensitivity. If the visual acuity was less than 1.0, contrast sensitivity was decreased, but decreased contrast sensitivity was also observed in four eyes with normal visual acuity, indicating that the level of visual deficit may not be established by measurement of visual acuity alone.
Bouzas, E. and G. Mastorakos (1994). "Central serous retinopathy in systemic lupus erythematosus: a manifestation of the disease or of its treatment?" Br J Ophthalmol 78(5): 420-1.
Lachapelle, K., M. Ballantyne, et al. (1994). "Chronic benign retinal pigment epithelial detachment: a subtype of central serous choroidopathy." Can J Ophthalmol 29(2): 70-2.
Between October 1983 and December 1991, 14 patients (mean age 48.1 [range 38 to 68] years) presented with single, clear, cystic-appearing juxtafoveal lesions beneath the retina, with discrete borders measuring approximately 2 mm in diameter. All patients had vision of 6/7.5 or better, which did not deteriorate over a follow-up period of 3 to 91 (mean 18.1) months. Angiographically, the lesions showed relative homogeneous hyperfluorescence with very discrete margins, the angiographic appearance of serous retinal pigment epithelial detachment. We describe the clinical and angiographic appearance on presentation and in follow-up and discuss the probable relationship of these lesions to central serous choroidopathy.
Piccolino, F. C. and L. Borgia (1994). "Central serous chorioretinopathy and indocyanine green angiography." Retina 14(3): 231-42.
BACKGROUND: Because of limitations in imaging through the retinal pigment epithelium (RPE), fluorescein angiography has not been able to characterize the choroidal abnormalities that are thought to be causative factors in central serous chorioretinopathy (CSC). METHODS: Digital indocyanine green (ICG) videoangiography and fluorescein angiography were performed in 34 consecutive patients with various forms of CSC to investigate choroidal abnormalities. RESULTS: The ICG videoangiographic studies revealed choroidal staining in association with active, spontaneously resolved, and previously photocoagulated pigment epithelial leaks documented with fluorescein angiography. In the space of a few minutes, the dye progressively spread outward from the region of choroidal staining. CONCLUSION: Localized hyperpermeability of the choriocapillaris, probably associated with segmental choroidal hyperperfusion, may be a causative factor of characteristic RPE and neurosensory retinal exudative changes in CSC.
Samy, C. N. and E. S. Gragoudas (1994). "Laser photocoagulation treatment of central serous chorioretinopathy." Int Ophthalmol Clin 34(3): 109-19.
Browning, D. J. (1993). "Nadolol in the treatment of central serous retinopathy." Am J Ophthalmol 116(6): 770-1.
Schatz, H., M. D. Osterloh, et al. (1993). "Development of retinal vascular leakage and cystoid macular oedema secondary to central serous chorioretinopathy." Br J Ophthalmol 77(11): 744-6.
Ulbig, M. R., P. Riordan-Eva, et al. (1993). "Membranoproliferative glomerulonephritis type II associated with central serous retinopathy." Am J Ophthalmol 116(4): 410-3.
Membranoproliferative glomerulonephritis type II is specifically associated with the presence of dense deposits in the basement membrane of Bruch's membrane, which result in lesions similar to basal laminar drusen, exudative drusen, and retinal pigment epithelial detachments. In advanced stages of this dense-deposit retinopathy, choroidal neovascularization may occur. We observed a 36-year-old patient with membranoproliferative glomerulonephritis type II who developed central serous retinopathy in the presence of specific dense-deposit-associated fundus lesions. The diffuse drusenlike dense deposits (at the level of Bruch's membrane) and associated retinal pigment epithelial detachments appear to contribute to the pathogenesis of central serous retinopathy. Thus changes in Bruch's membrane may be involved in the development of central serous retinopathy.
Bouzas, E. A., M. H. Scott, et al. (1993). "Central serous chorioretinopathy in endogenous hypercortisolism." Arch Ophthalmol 111(9): 1229-33.
OBJECTIVE: To examine the potential association of central serous chorioretinopathy with endogenous hypercortisolism (Cushing's syndrome). DESIGN: Ophthalmologic survey of consecutively admitted patients with endogenous Cushing's syndrome. SETTING: An eye clinic of a research center (National Eye Institute, Bethesda, Md). PATIENTS: Sixty consecutive patients with confirmed endogenous Cushing's syndrome. MAIN OUTCOME MEASURES: Findings from complete ophthalmologic evaluation. RESULTS: Three (5%) of 60 patients had one or more episodes of appropriately documented central serous chorioretinopathy. In all cases, the episodes occurred during the period of hypercortisolism. CONCLUSIONS: Central serous chorioretinopathy is an uncommon manifestation of endogenous Cushing's syndrome. Since central serous chorioretinopathy has been associated with other hypercortisolemic states, we suggest that glucocorticoids may play a role in the development of this disease.
Eckstein, M. B., D. J. Spalton, et al. (1993). "Visual loss from central serous retinopathy in systemic lupus erythematosus." Br J Ophthalmol 77(9): 607-9.
Anderson, S. F. and J. C. Townsend (1993). "Central serous chorioretinopathy complicated by subsequent occipital lobe infarction and sinusitis in a drug abuser." J Am Optom Assoc 64(8): 557-62.
BACKGROUND: The presence of multiple occurring, simultaneously complicated clinical findings can be challenging. METHODS: A 39-year-old white male presented initially with central serous chorioretinopathy. Later, the patient reported a great deal of pain over his left eye with nasal vision loss. Comprehensive ophthalmic evaluation and neurologic consultation were invaluable in the diagnosis and management of the patient. RESULTS: Neurologic consultation along with computed tomography (CT) of the head with and without contrast enhancement along with magnetic resonance imaging (MRI) with and without gadolinium revealed lesions in the left occipital lobe, right cerebellum, and left thalamus area. In addition, bilateral maxillary and ethmoidal sinusitis were observed. CONCLUSIONS: Multiple events affecting vision are often related, sometimes not. However, co-existing factors can confound and obscure accurate diagnoses. Careful patient clinical and laboratory investigations are frequently necessary to elucidate correct diagnosis.
Yamada, R., S. Yamada, et al. (1993). "[Evaluation of tissue plasminogen activator and plasminogen activator inhibitor-1 in blood obtained from patients of idiopathic central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 97(8): 955-60.
It is postulated that idiopathic central serous chorioretinopathy (ICSC) may be induced by a variety of underlying choroidal diseases capable of producing initially alterations in the permeability of the choriocapillaries. A history of unusual emotional stress frequently accompanies the onset of visual complaints. We have reported that alterations of serum lipids may exert a powerful effect on tissue plasminogen activator (t-PA) levels acting as a risk factor of variable cardioangiopathies. In this study, we evaluated the levels of t-PA activity, t-PA antigen and plasminogen activator inhibitor-1 (PAI-1) in blood from the patients with central serous chorioretinopathy, and compared them with the levels of total cholesterols (TCH), triglycerides (TG), and high-density lipoprotein cholesterol (HDL). t-PA activity levels and HDL were lower than in standard controls but t-PA antigen, PAI-1 antigen, and TG were higher. These facts may be associated with the pathogenesis or pathophysiological features of ICSC.
Ie, D., L. A. Yannuzzi, et al. (1993). "Subretinal exudative deposits in central serous chorioretinopathy." Br J Ophthalmol 77(6): 349-53.
The presence of subretinal exudation in a patient with neurosensory detachment of the macula frequently suggests the diagnosis of choroidal neovascularisation. A retrospective chart review of newly diagnosed cases of central serous chorioretinopathy revealed 11 patients, seven men and four non-pregnant women, who had plaques of subretinal exudate, which presumably were fibrin. Each of these patients had a solitary plaque that ranged in size from 300 to 1500 microns in diameter. These patients had no signs or a clinical course suggestive of choroidal neovascularisation. In each case the subretinal plaque was overlying an exuberant leak in the retinal pigment epithelium. The exudate was generally present at the initial examination, and usually showed dissolution before or coincident with the resolution of the neurosensory detachment. After resolution of the central serous chorioretinopathy, patients were left with subtle alterations in the retinal pigment epithelium in the areas of the subretinal plaque. These findings are important for two reasons. Firstly, the presence of subretinal exudation does not necessarily rule out the diagnosis of central serous chorioretinopathy. Secondly, pathophysiological theories of central serous chorioretinopathy must explain how the plaques are deposited behind the retina.
Avci, R. and A. F. Deutman (1993). "[Treatment of central serous choroidopathy with the beta receptor blocker metoprolol (preliminary results)]." Klin Monatsbl Augenheilkd 202(3): 199-205.
Numerous theories have been proposed to explain the origin of central serous choroidopathy (CSC). However, it has been shown recently that there is a close relationship between CSC and type A-behaviour pattern (TABP) which is characterized by high adrenergic activity in the body. It is interesting to note that one of our patients who had chronic central serous choroidopathy, and metoprolol treatment for hypertension during one year, developed a recurrence of CSC three weeks after cessation of metoprolol treatment. This was one of the reasons to start this treatment modality for CSC. In this study, we present 6 cases of CSC in which the diagnosis was established by ophthalmoscopy and fluorescein angiography. In these patients, we proposed to analyse the relationship between CSC and a high adrenergic activity by the use of a selective beta-blocker (metoprolol; 50 mg tablets, twice daily). In two of the six cases, laser photocoagulation was also performed prior to commencement of the metoprolol treatment. Visual acuity improved in two patients, stayed at 1.0 in three patients and stabilized on the pretreatment level (0.8) in one patient (case-5). However, the symptoms (metamorphopsia and micropsia) and the signs (serous retinal detachment and angiographic hyperfluorescence) decreased or disappeared in all patients after treatment. Also visual complaints in all patients improved subjectively. No recurrences were noted during the metoprolol treatment in any of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Sunness, J. S., J. A. Haller, et al. (1993). "Central serous chorioretinopathy and pregnancy." Arch Ophthalmol 111(3): 360-4.
BACKGROUND AND OBJECTIVE--Fourteen cases of central serous chorioretinopathy in pregnancy had been reported before this study was conducted. These cases have suggested a nonwhite predominance. Subretinal fibrinous exudates have been seen in 90% of the patients, compared with fewer than 20% of patients in typical (nonpregnant) central serous chorioretinopathy. No case has recurred outside of pregnancy, to our knowledge, and there have been no reports of subsequent pregnancies uninvolved by this disorder. These findings led us to collect our cases of central serous retinopathy in pregnancy because our experience differed from that of previous reports and provides additional new information. DESIGN--Case series. SETTING--The Wilmer Institute Retinal Vascular Center, Baltimore, Md. PATIENTS--Questionnaires sent to retinal faculty and fellows and a review of files revealed four patients, all included herein, with central serous chorioretinopathy presenting during pregnancy. RESULTS--All four patients were white. Three patients had subretinal fibrinous exudates and/or precipitates. All experienced resolution of the serous detachment near the end of the pregnancy or within the first few months after delivery. Only one patient had a subsequent pregnancy, and this was not complicated by the presence of central serous chorioretinopathy. One other patient experienced a recurrence 2 1/2 years after her last pregnancy. CONCLUSIONS--There may be no racial predominance in the development of central serous chorioretinopathy in pregnancy. Subretinal fibrinous exudates are quite common, independent of race. The uninvolved subsequent pregnancy suggests that recurrence in the context of pregnancy is not inevitable. This disorder may recur outside of pregnancy.
Gomez-Ulla, F., I. Seoane, et al. (1993). "An image analyzer study of central serous chorioretinopathy." Optom Vis Sci 70(2): 118-22.
The angiographic characteristics of central serous chorioretinopathy (CSC) were studied by analyzing digitalized angiograms with an IMAGEnet system. We determined the type of leak, its location, and its distance from the fovea and from the center of the detachment. Round leaks were located farther from the detachment center and farther from the fovea than smokestack leaks. Detachments tended to center on the fovea regardless of the leak to fovea distance. These findings suggest that for serous detachment of the sensory retina to develop and be maintained, there must be a diffuse dysfunctional area of retinal pigment epithelium and a focal leak.
Scheider, A., J. E. Nasemann, et al. (1993). "Fluorescein and indocyanine green angiographies of central serous choroidopathy by scanning laser ophthalmoscopy." Am J Ophthalmol 115(1): 50-6.
We examined 19 patients (41 +/- 7.5 years old) with central serous chorioretinopathy and symptoms that ranged from one day to 24 months. Fluorescein and indocyanine green angiographies were performed with a scanning laser ophthalmoscope. Focal exudation was found in all patients with fluorescein and in 15 patients (79%) with indocyanine green. We found a more widespread exudation of indocyanine green into the choroid around the focal hyperfluorescent spot in seven patients (37%). Perfusion with fluorescein was delayed in the area of focal exudation in two patients (11%) and with indocyanine green in 12 patients (63%). Exudation of both dyes stopped with clinical improvement, whereas the perfusion deficits remained unchanged. These results further indicate that central serous chorioretinopathy is primarily a choroidal disease.
Ndiaye, P. A., F. Aouizerate, et al. (1993). "[Posterior form of persistent hyperplasia of the primary vitreous body associated with central serous chorioretinopathy]." J Fr Ophtalmol 16(5): 333-6.
The authors report a case of posterior hyperplastic primary vitreous which was associated by chance with a central serous choroidoretinopathy. Examination of the left eye revealed a dense white vitreous condensation attached to the optic disc associated with retinal folds. Fluorescein Angiography showed a typical central serous choroidoretinopathy. No treatment was required as retinal complications due to the posterior hyperplastic primary vitreous were not found; central serous choroidoretinopathy had a satisfactory course. Posterior hyperplastic primary vitreous is a rare disease, different from Reese's anterior form and may mimic congenital abnormalities of the optic disc. Clinical appearance, clinical course and treatment are discussed.
Ko, W. (1992). "Central serous chorioretinopathy associated with pregnancy." J Ophthalmic Nurs Technol 11(5): 203-5.
Central serous chorioretinopathy is an infrequent but benign complication of pregnancy that is found largely in the minority population. White subretinal exudates and multiple recurrences are frequently seen with the central serous chorioretinopathy of pregnancy. Central serous chorioretinopathy usually spontaneously resolves with minimal sequelae without intervention after delivery of the baby.
Lu, N. and C. Zhang (1992). "[Contrast sensitivity study in the fellow eyes of patients with central serous chorioretinopathy]." Zhongguo Yi Xue Ke Xue Yuan Xue Bao 14(2): 85-8.
In clinical practice, it has been shown that the contrast sensitivity (CS) test is one of the most sensitive visual functional tests. In our experiment, we used a U.S.-made VCTS 60000 CS test plate to test the fellow eyes (20) of 20 cases with unilateral central serous chorioretinopathy (CSC), along with age-matched normal controls. From the control group, we obtained a group of bell-shaped normal CS curves which showed some degree of decrease with age. 40% of the fellow eyes of the patient group showed a slight CS decrease at mid-high spatial frequencies, though other visual functional tests show no abnormality. These fellow eyes may be at risk for CSC. Our experiment, for the first time, showed the possibility of using the CS test as a diagnostic test for subclinical CSC.
Hisada, H. and S. Awaya (1992). "[Aniseikonia of central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 96(3): 369-74.
Central serous chorioretinopathy (CRS) is one of the typical diseases that accompany micropsia. However very little is known about micropsia of CRS, because of the difficulty to measure "aniseikonia" in terms of micropsia. Aniseikonia in 65 cases of CRS was measured quantitatively by Awaya's New Aniseikonia Tests (NAT). The tests were performed at two different distances of 40 cm (visual angle: 6 degrees) and 20 cm (12 degrees) and under 4 meridians of the halfmoon on NAT, horizontal, 45 degrees, vertical and 135 degrees, respectively. The mean value of aniseikonia under each testing condition was as follows: 6 degrees horizontal -3.13%, 45 degrees -2.56%, vertical -2.13%, 135 degrees -2.57%, 12 degrees; horizontal -1.38%, 45 degrees -1.69%, vertical -1.84%, 135 degrees -1.50%. At 6 degrees aniseikonia is larger in the horizontal meridian than in the vertical with statistical significance (t-test, p less than 0.05), while at 12 degrees aniseikonia is smaller than at 6 degrees and shows no particular tendency in terms of meridian. The phenomenon observed at 6 degrees may be what is called "oriented metamorphopsia".
Ustinova, E. I. (1992). "[Central serous choroidopathy: problems of etiology and clinical aspects]." Vestn Oftalmol 108(2): 24-6.
Examinations of 35 patients hospitalized after long ineffective antituberculous therapy on an outpatient basis have revealed serous detachment of pigmented epithelium or neuroepithelium of the retina in 17, hemorrhagic detachment of pigmented epithelium and neuroepithelium in 12, and residual symptoms of these conditions with macular dystrophy signs in 6 of these patients. The absence of chorioretinal foci that are characteristic of tuberculous inflammation of ocular internal membranes, absence of focal reactions in tuberculin diagnosis and no therapeutic effect in antituberculous therapy evidenced a nontuberculous origin of the disease. Fluorescent angiographic examination of the fundus oculi has confirmed the clinical diagnosis of central serous choroidopathy in 18 of 23 cases. The author emphasizes a nontuberculous etiology of central serous choroidopathy and suggests that three stages be distinguished in the clinical picture of this condition: serous, hemorrhagic and dystrophic.
Schatz, H., D. Madeira, et al. (1992). "Central serous chorioretinopathy occurring in patients 60 years of age and older." Ophthalmology 99(1): 63-7.
The authors report on 13 eyes in 13 patients, 60 years of age or older, with idiopathic central serous chorioretinopathy, a condition that typically presents in adults between the ages of 30 and 50 years. In older patients, this condition can easily be mistaken for macular degeneration with subretinal neovascularization. None of the patients in this series had soft drusen, geographic atrophy, or subretinal neovascularization, signs of age-related macular degeneration or other retinal or macular disease. Subretinal neovascularization was not seen either at the time of initial diagnosis or during follow-up. The clinical, biomicroscopic, and fluorescein angiographic characteristics of this entity are described. The clinical course of 7 of these 13 eyes that underwent laser photocoagulation treatment is also described.
Castro-Correia, J., M. F. Coutinho, et al. (1992). "Long-term follow-up of central serous retinopathy in 150 patients." Doc Ophthalmol 81(4): 379-86.
To study the evolution of the retinal pigment epithelial lesions in the central serous retinopathy, the authors studied 150 patients with ages between 20 and 49 years at the first examination, during periods varying between 6 months and 14 years. It was found a greater incidence of the disease in the males (83.3%); bilaterality in 23.3%; only one point of leakage in 62.7%; 3 different types of diffusion (inkblot 71.4%; mushroom 23.8%; with serous pigment epithelial detachment 4.9%). The final visual acuity was < 20/40 in a quarter of the cases and the frequency of the recurrences was 30%. The laser treatment did not influence the recurrences. In 50 patients with a follow-up superior to 3 years, 8 (16%) developed lesions similar to those described as diffuse retinal pigment epitheliopathy with visual field defects and subnormal EOG. Actuarial calculus suggests that 50% of the patients may get the most severe and extensive form of the disease after 12 years of evolution. The results allow to conclude that the diffuse retinal pigment epitheliopathy is only the terminal state of the most severe cases of central serous retinopathy.
Yamada, K., S. Hayasaka, et al. (1992). "Fluorescein-angiographic patterns in patients with central serous chorioretinopathy at the initial visit." Ophthalmologica 205(2): 69-76.
We reviewed the clinical records, color photographs and fluorescein angiograms of 106 eyes of 53 patients (44 men and 9 women) with central serous chorioretinopathy who had been followed up for 1 year or more. Their ages ranged from 20 to 59 years. One eye in each patient was involved at the initial visit. According to fluorescein-angiographic findings, the lesions were divided into smokestack pattern (13 eyes), ink blot appearance (33 eyes) and minimally enlarging spot (7 eyes). Most patients complained of central scotoma, and most patients had moderately decreased visual acuities at the initial visit, which improved after recovery. In particular, all 7 eyes with a minimally enlarging spot had a visual acuity of 0.8 or more at the initial visit; of these 6 eyes had 1.0 or more several weeks later. On fluorescein angiography, 49 eyes demonstrated 1 leaking spot and 4 eyes showed 2 spots. Of 57 leaking spots, 10 were observed in the foveola, 31 were noted in the fovea and 16 were found in the para- or perifovea. Of 13 smokestack patterns, 5 were found in the inferonasal area. The ink blot appearance and minimally enlarging spots were frequently found in the superonasal and superotemporal areas.
Piccolino, F. C. (1992). "Laser treatment of eccentric leaks in central serous chorioretinopathy resulting in disappearance of untreated juxtafoveal leaks." Retina 12(2): 96-102.
In central serous chorioretinopathy (CSCR) laser treatment of leaking points close to the macular center should be avoided because of the possibility of producing juxtafoveal scotoma and stimulating choroidal neovascularization. Nine eyes of nine consecutive patients with CSCR had two or more leaking points within a macular detachment, one of which was foveal or near to the fovea. Photocoagulation with green argon laser was performed in all eyes, treating all the leaking points except for the central one. Visual symptoms regressed after treatment, and the serous detachment was resolved 10 days to 4 weeks after photocoagulation in all cases. Fluorescein angiography showed no leakage at either the central leakage point or the leakage point that had been treated. These results led us to believe that the central or dependent leak in our cases was not sufficient to maintain the serous detachment by itself. An alternative hypothesis is that the untreated leak did not represent real fluid movement but only diffusion of fluorescein molecules, or a false leak. In cases of CSCR with multiple leaks within a single macular detachment, we believe that a foveal leak may be a dependent or false leak and that direct treatment is not necessary.
Weiler, W., M. H. Foerster, et al. (1991). "[Exudative retinal detachment, pigment epithelium tear and subretinal exudate in a case of central serous retinopathy]." Klin Monatsbl Augenheilkd 199(6): 450-3.
A thirty year old patient with central serous chorioretinopathy on his right eye is presented. The signs of his disease were exsudative retinal detachment with shifting fluid, rip of the retinal pigmentepithelium and a mass of whitish-yellowish subretinal protein. After the diagnosis was made light-coagulation was performed. Within half a year the retina reattached completely, most of the subretinal protein was reabsorbed and vision slowly normalized.
Yoshioka, H. (1991). "[The etiology of central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 95(12): 1181-95.
We found several fluorescein fundus angiographic findings of the retinal pigment epithelium in the experimental central serous chorioretinopathy (ECSC) i.e.; the typical leaking spot (smoke-stack type or inkblot type), acute retinal pigment epitheliitis-like, APMPPE-like, triangular syndrome-like, drusen-like lesions, and retinal pigment epithelium decompensation during the observations of the six months period in the same monkey. Immediately after onset of ECSC, we found that the typical leaking spot appeared after retinal venous filling phase or appeared in the margin of the choroidal filling delay. The leaking spot, acute retinal pigment epitheliitis-like, APMPPE-like and drusen-like lesions spontaneously healed without scar formation and were related to the mild choroidal ischemia. These findings correspond to those seen in human central serous chorioretinopathy. As an initial change, choroidal neovascularization in the macula was also found in the eye with recurrent or chronic ECSC by electron microscopy. Considering the fluorescein fundus angiographic findings of this monkey, it was suggested that the recurrent or chronic, mild choroidal ischemia seems to play an important role in the development of the choroidal neovascularization. Therefore, we believe that the ECSC is an animal model of the human central serous chorioretinopathy. We also found that the development of ECSC produced by intravenous injection of the adrenalin in rabbits is completely suppressed by the pretreatment of alpha-adrenergic receptor blocking agent and is incompletely suppressed by the pretreatment of beta adrenergic receptor blocking agent and ganglionic blocking agent. These results strongly suggest that the stress plays an important role in the development of the central serous chorioretinopathy.
Berger, A. R., R. J. Olk, et al. (1991). "Central serous choroidopathy in patients over 50 years of age." Ophthalmic Surg 22(10): 583-90.
Reviewing all records of patients with the diagnosis of central serous choroidopathy (CSC) at Retina Consultants, Ltd since 1975, we identified 47 patients with CSC who were older than 50 years at initial presentation. These patients were divided into three groups, based on type of management: observation; light "CSC-type" photocoagulation; and heavy "subretinal-neovascular-membrane (SRNVM)-type" photocoagulation. Although most of these patients retained excellent central visual acuity, overall final visual acuities were poorer than those in other reported series. Heavier photocoagulation, as compared with lighter treatment, was associated with a decreased incidence of posttreatment SRNVM formation and appeared to have no adverse effect on final visual outcome. Patients with multiple irregular leaks on fluorescein angiography had a greater tendency to develop SRNVMs, with or without treatment. Ophthalmologists diagnosing CSC in patients over age 50 should be aware that there is a greater risk of SRNVM developing in these patients.
Palenga-Pydyn, D. and K. Dziegielewski (1991). "[The role of laser therapy in central serous choroidopathy]." Klin Oczna 93(10-11): 304-5.
The authors present early results of treatment of central serous choroidopathy by means of argon laser. Additionally they compare the fate of the patients with this condition treated conservatively in the last years. The results obtained confirm the world reports that application of laser in therapy of central serous choroidopathy shortens the course of the disease.
Palenga-Pydyn, D. and K. Dziegielewski (1991). "[Current views on the pathogenesis and treatment of central serous choroidopathy]." Klin Oczna 93(10-11): 301-3.
The majority of authors as a cause of formation of a leakage in central serous choroidopathy considers the disturbances of function of the pigmentary layer. According to Spitznas it is based on transformation of these cells from absorbing to extracting towards the choroid and retina under the influence of unknown factors (immunological processes, circulatory, inflammatory factors or stress). Marmor sees the lesion of the pigmentary epithelium as a disturbance of a cyclic action of the AMP neeth the neurosensory layer of the retina. There exist contemporary 2 methods of treatment of the central serous retinopathy. One part of the authors thinks that one should wait till the spontaneous remission, the other one--that in cases with the leakage situated beyond the risk area laser therapy can be applied.
Jalali, S., A. Gupta, et al. (1991). "Visual prognosis in central serous choroidopathy: residual Amsler grid changes." Can J Ophthalmol 26(5): 270-2.
To assess residual changes on Amsler grid charting in central serous choroidopathy, 30 patients (34 eyes) with the disorder were followed from the time of onset of symptoms to the time of resolution of the disease. A total of 28 eyes, including all 3 with an acuity of 6/6 or better, had Amsler grid changes at presentation, compared with 13 eyes at the last follow-up visit. Significantly more patients with a disease duration of more than 8 weeks than those whose disease lasted 8 weeks or less had residual changes (p less than 0.01). Overall, 41% of the eyes had a final acuity of less than 6/6 or a residual change or both.
Yamaguchi, K., Y. Kin-para, et al. (1991). "Idiopathic central serous choroidopathy in a patient with pericentral pigmentary retinal degeneration." Ann Ophthalmol 23(7): 251-3.
A 35-year-old man with pericentral pigmentary retinal degeneration also had idiopathic central serous choroidopathy OU. This case report describes a rare coexistence of two independent diseases.
Gass, J. D. (1991). "Central serous chorioretinopathy and white subretinal exudation during pregnancy." Arch Ophthalmol 109(5): 677-81.
Six otherwise healthy pregnant women had development of idiopathic central serous chorioretinopathy in one or both eyes. All had one or more focal areas of white subretinal exudate, which probably was fibrinous in type. In some patients, this was misinterpreted as subretinal neovascularization or retinitis. Symptoms developed in most patients in the third trimester and following delivery, there was spontaneous resolution of retinal detachment and return of visual acuity to 20/20 or better. In a randomly selected group of 50 patients with idiopathic central serous retinopathy unassociated with pregnancy, subretinal white exudation occurred in only six (17%) of 42 men and in zero (0%) of eight women. The cause for the higher prevalence of this exudate in pregnant women is unknown.
Brancato, R. and F. Bandello (1991). "[Central serous retinopathy (atypical forms)]." Bull Soc Belge Ophtalmol 240: 119-31.
In comparison with the typical forms of the central serous chorioretinopathy (CSCR), atypical forms are characterized by an older age, the presence of multiple and bilateral foci, the higher tendency for recurrence and the more accentuated functional damages. They may take the form of DRPE (diffuse retinal pigment epitheliopathy) and of gravitational epitheliopathy. Sedative therapy is justified by the particular psychic background which often accompanies this disease. Photocoagulation must be performed only in very selected cases in order to reduce the damage at the level of the macular photoreceptors.
Shiroyama, N. and Y. Miyake (1990). "[Analysis of focal macular ERG in idiopathic central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 94(11): 1048-56.
Focal macular electroretinogram (MERG), was analyzed in 33 patients with unilateral central serous chorioretinopathy (CSC) of recent onset. The stimulus spots were 5 degrees, 10 degrees and 15 degrees in diameter. Nonaffected fellow eyes served as controls. When macular detachment was present, the MERG showed significantly reduced amplitude and delayed peak latency in a-wave, b-wave and oscillatory potentials (OPs) in all stimulus spots. The reduction of amplitude in 5 degree and 10 degree spots was more significant in b-wave and OPs than in a-wave. In the convalescent stage, the a-wave and b-wave recovered to nearly normal levels, however OPs showed selective delay of recovery. These abnormalities shown by MERG strongly suggest that CSC may involve functional disturbances in the inner retinal layer as well as photoreceptors. It has been assumed that the pathogenic properties of CSC are receptor disorientation and a disturbance in the rate of photopigment regeneration. The present study showed that the abnormal pattern of MERG in CSC cannot be explained simply by the assumption of receptor disorientation or a disturbance of photopigment regeneration by analyzing similar conditions in normal eyes.
Rathschuler, F., S. Lai, et al. (1990). "A new therapeutical approach to central serous retinopathy, a hypothesis." Int Ophthalmol 14(2): 125-9.
The authors report two cases of patients affected by Central Serous Retinopathy (C.S.R.) lasting few days; they were immediately started with an antiviral therapy (Acycloguanosine) for few days and in both cases the regression of symptoms and a flat retina were observed after a very shorter time than the spontaneous course. A fluorescein angiography confirmed a healing of the leaking points very few days after the therapy was discontinued. The authors discuss their finding in relation to the latest hypothesis on C.S.R. pathogenesis.
Friberg, T. R. and A. W. Eller (1990). "Serous retinal detachment resembling central serous chorioretinopathy following organ transplantation." Graefes Arch Clin Exp Ophthalmol 228(4): 305-9.
Two patients developed unilateral serous retinal detachments of the macula resembling idiopathic center serous chorioretinopathy within 9 months of cardiac transplantation, while one renal transplant recipient developed bilateral serous detachments within 6 months of surgery. In two cases (three eyes), dense, yellow, fibrlin-like exudates were present in the subretinal fluid. At the time of presentation, each of the three patients had a modest elevation of blood urea nitrogen. Laser photocoagulation was performed in three eyes with limited success, although ultimately the detachments resolved leaving only mild visual impairment (6/9 vision). The differential diagnosis of visual loss in the transplant population includes serous detachment of the sensory retina as well as more serious chorioretinal infections related to immunosuppression.
Orzalesi, N., F. Bottoni, et al. (1990). "Is there a role for cone interphotoreceptor matrix in the pathogenesis of central serous chorioretinopathy?" Ophthalmologica 201(1): 49-51.
Verma, S. K. and A. S. Sahai (1990). "Macular dazzling test in central serous retinopathy using electronic flash." Indian J Ophthalmol 38(1): 14-6.
Recovery time after dazzling the macula by conventional electronic flash used by the photographer instead of the light of an ophthalmoscope was recorded in 100 normal subjects and 50 cases of active central serous retinopathy. In normal subjects the recovery time after macular dazzling test was 10 to 54 seconds. There was no difference in value between the two sexes. The recovery value increases with the advancement of age. The recovery time was 10 to 15 minutes in cases of active central serous retinopathy and there was no delay in recovery time in healed central serous retinopathy. The values elicited by electronic flash were repeatable in comparison to the technique of dazzling the macula by light of an ophthalmoscope.
Weinberger, D., I. Kremer, et al. (1990). "The treatment of foveal central serous choroidopathy by krypton red laser." Ann Ophthalmol 22(1): 35-8.
We present 24 patients with recent foveal central serous choroidopathy. Only those in whom the leakage site was located within a radius of 250 microns from the foveal center were included in this study. All patients were treated with the krypton red laser (647 nm) within a week of the clinical diagnosis. At the end of the follow-up, 70.8% of the patients had a visual acuity of 6/8.5 or better, and an overall visual improvement was found in 83.3%. In 90% of the patients whose vision improved, significant absorption of subretinal fluid was seen within three weeks and in 10% within four weeks. No evidence of any macular pathology complicating the laser treatment was found at the end of the follow-up period of at least 36 months.
Karhan, J. and M. Vymazal (1990). "Present views of the pathogenesis and treatment of central serous chorioretinopathy." Acta Univ Palacki Olomuc Fac Med 126: 219-26.
The central serous chorioretinopathy is a disease which has been known since 1866. Even the papers published in recent time did not report anything unequivocal concerning its etiology which remains obscure. A year ago, Spitznas submitted a new interesting working hypothesis to explain the pathogenesis of this disease. At present, in the treatment of CSCH, the method of choice is the direct laser photocoagulation. The best results are so far obtained with the treatment using the red crypton laser beam. This is due to its biological effects on the tissues of the eye. The effects of the selected green beam of the argon laser are similar to those of the red crypton light. In accordance with our experiences, its application is useful for direct photocoagulation of CSCH. It does not lead to the development of a positive central scotoma and that not even in close proximity of the foveola up to the distance of 200 microns from the avascular zone. This is given by its biological effects and the small extent of the coagulated area of the retina. When the leakage is nearer than 200 microns from the margin of the avascular zone of the foveola, it is suitable to treat CSCH conservatively. The risk of a permanent iatrogenic damage of the central visual acuity or the development of subretinal neovascular membranes is minimal on direct photocoagulation of CSCH with green light of the argon laser under simultaneous fluoroscopy, and utilization of suitable parameters of the treatment. The clinician must, however, take this risk into consideration when contemplating the advantage which is gained, namely the shortening of the duration of the disease.
Snyers, B. and C. Kestens (1990). "[Central serous choroiditis following renal transplantation]." Bull Soc Belge Ophtalmol 239: 87-101.
Report of 5 cases of central serous choroidopathy (CSC) following kidney transplantation. The authors compare the clinical features, the fluorescein angiography, the color vision, the visual field and the electrophysiological tests of these 5 cases with 7 control patients. In the pathogenesis of the CSC, the authors briefly discuss about the risk factors associated with the transplantation.
Freiwald, R., V. Seiberth, et al. (1990). "[Therapy of central serous detachment in papillary coloboma. A case report]." Fortschr Ophthalmol 87(6): 571-3.
A central retinal detachment caused by coloboma of the optic nerve head in one eye of a 34-year-old Caucasian male was treated successfully by pars-plana vitrectomy, endodiathermy of the hole situated at the periphery of the optic nerve head, drainage of the subretinal fluid and injection of silicone oil into the vitreous cavity. After removal of the silicone oil, the retina was still attached and the retinal function was unchanged. The clinical course is described.
Mutlak, J. A., G. N. Dutton, et al. (1989). "Central visual function in patients with resolved central serous retinopathy. A long term follow-up study." Acta Ophthalmol (Copenh) 67(5): 532-6.
The visual acuity, central retinal sensitivity, macular thresholds, contrast sensitivity and temporal visual acuity were employed to assess the long term visual outcome in 23 patients with a history of central serous retinopathy (CSR). Twenty patients had unilateral CSR, and 3 had had bilateral disease. The unaffected eyes had significantly better visual acuities (P less than 0.014), better retinal sensitivities (P less than 0.006) and lower macular thresholds (P less than 0.008) when compared with affected eyes. The eyes with CSR whose visual acuities were mildly affected (6/9) showed lower sensitivity for the high spatial frequency (P less than 0.0072). There was no significant difference in the temporal visual acuity between eyes with CSR and the non-affected eyes.
Moisseiev, J., M. Cahane, et al. (1989). "Optic nerve head drusen and peripapillary central serous chorioretinopathy." Am J Ophthalmol 108(2): 202-3.
Mutlak, J. A. and G. N. Dutton (1989). "Fluorescein angiographic features of acute central serous retinopathy. A retrospective study." Acta Ophthalmol (Copenh) 67(4): 467-9.
Vlkova, E., J. Preisova, et al. (1989). "[Central serous retinopathy as the first manifestation of malignant melanoma of the choroid]." Cesk Oftalmol 45(4): 276-8.
The authors give an account of 12 patients where the original ophthalmological finding corresponded to central serous retinitis. In the course of check-up examinations the picture changed and finally the complex of applied examinations revealed that a malignant melanoma of the choroid was involved. The authors mention the time needed for the clinical decision on the final diagnosis of the disease which was confirmed histologically after enucleation of the eye. In the conclusion the authors draw attention to the necessity of frequent check-up examinations after the initial establishment of the diagnosis of central serous retinitis with regard to the differential diagnostic possibilities of the above disease.
Charman, W. N. (1989). "Symptoms in central serous retinopathy." Ophthalmic Physiol Opt 9(3): 340-2.
Levine, R., A. J. Brucker, et al. (1989). "Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography." Ophthalmology 96(6): 854-9.
Idiopathic central serous chorioretinopathy (ICSC) is typically described as a self-limited, unilateral disease that affects healthy, young adult males. The authors studied 13 patients (14 eyes) who had documented spontaneous resolution of symptomatic macular detachments. These patients were evaluated in a longitudinal fashion to determine the fate of the retinal pigment epithelium (RPE) as viewed angiographically, both in the initially affected eyes and the fellow eyes. At the time of follow-up examination of the initially affected eyes, nonleaking RPE defects had developed inside the areas of previous serous detachment in all cases. Nonleaking RPE defects had developed outside these areas in six (43%) eyes. Two (14%) eyes had new, asymptomatic macular detachments. Six (42%) fellow eyes had new RPE window defects; two (17%) of them also had active RPE dye leakage resulting in asymptomatic macular detachment at the final examination. Four (29%) originally involved eyes and one (8%) fellow eye lost more than two lines of Snellen visual acuity during the follow-up period. The authors' results suggest that ICSC may be a progressive bilateral disease that develops asymmetrically and causes diffuse RPE changes not localized to the area of serous detachment. Long-term follow-up of these patients may, therefore, be advisable.
Yospaiboon, Y. and A. Prabriputaloong (1989). "Early laser photocoagulation for idiopathic central serous choroidopathy." J Med Assoc Thai 72(3): 138-43.
Prolonged or recurrent serous detachment at the macula may cause permanent visual impairment in patients with idiopathic central serous choroidopathy. Early treatment and early resolution of the disease are therefore hypothesized to prevent this visual deficit. In this study, early laser photocoagulation of the leakage site in 25 patients with idiopathic central serous choroidopathy was performed, as compared to 25 control patients. The results of the study were promising. Rapid absorption of subretinal fluid was noted in the laser-treated group (2.37 +/- 1.63 weeks), compared to the untreated control group (7.55 +/- 4.17 weeks). Early visual recovery was also noted in the laser-treated group. Moreover, there was no recurrence in the treated group after a one-year follow-up period. Contrast this with the control group who showed cumulative recurrent probability of 70.84 per cent by using Kaplan Meier survival analysis.
Gomolin, J. E. (1989). "Choroidal neovascularization and central serous chorioretinopathy." Can J Ophthalmol 24(1): 20-3.
Three forms of choroidal neovascularization may occur associated with central serous chorioretinopathy (CSC). Two have previously been reported and are briefly reviewed. The author presents a third, previously unreported pattern of choroidal neovascularization complicating untreated recurrent CSC.
Schreiber, J. B., V. Lakhanpal, et al. (1989). "Crohn's disease complicated by idiopathic central serous chorioretinopathy with bullous retinal detachment." Dig Dis Sci 34(1): 118-22.
A case of idiopathic central serous chorioretinopathy with bullous retinal detachment occurring in a patient with Crohn's disease is described. This rare eye condition (36 reported cases in the world's literature) has previously been seen in association with ulcerative colitis, and its occurrence in a patient with Crohn's disease suggests that it may represent another ophthalmologic complication of inflammatory bowel disease.
Moisseiev, J., D. Neuman, et al. (1989). "Idiopathic central serous choroidopathy (ICSC)." Retina 9(2): 153-4.
Friberg, T. R. and J. Campagna (1989). "Central serous chorioretinopathy: an analysis of the clinical morphology using image-processing techniques." Graefes Arch Clin Exp Ophthalmol 227(3): 201-5.
We used a digital image processor to make multiple measurements from the fluorescein angiograms of 53 cases of central serous chorioretinopathy (CSC) associated with single leaks. We determined the area of the base of each serous detachment, the location of its geometric center (CM), the area of the RPE leak, the distance from the fovea to the leak, and the distance from the leak to the CM. The distribution of leaks across the base of the detachments was nonrandom (P less than 0.005) with leaks clustering near the centers of the detachments. When the leak was found within 1 disc diameter from the fovea, the center of the detachment was located virtually at the foveola, suggesting that the central macula is predisposed to the development of CSC. Detachments associated with "smokestack" leaks were significantly larger than those associated with round pinpoint leaks (P less than 0.02).
Beuchat, L., F. Simona, et al. (1989). "[Evaluation of retinal function following central serous retinopathy and diffuse epithelial retinopathy]." Ophtalmologie 3(1): 57-61.
The so called "benign" central serous retinopathy is associated in healed forms with frequent and troublesome visual function impairment. The abnormalities are still more severe after diffuse retinal pigment epitheliopathy. Snellen visual testing is relatively imprecise index of visual function, so it does not permit to appreciate the subtle visual disturbances experienced by these patients. We evaluated visual function disability with static automatized perimetry and contrast sensitivity in 30 patients with diffuse epitheliopathy in a cicatricial phase. Colour vision was also evaluated by 16 patients after central serous retinopathy. The results of this study are examined and discussed.
Dickhoff, K. V., M. Hoffren, et al. (1989). "[Retinal pigment epithelial changes related to central serous retinopathy]." J Fr Ophtalmol 12(12): 877-81.
Thirty nine patients (7 females, 32 males) with central serous retinopathy (CSR) have been followed up for 1.6-17.0 years (mean 9.6 +/- 4.2). Eleven eyes had laser therapy, 7 during the initial attack, 4 at the time of the recurrent CSR. In the initial fluorescein angiograms pigment epithelial (PE) changes other than the leaking point were observed in 21 eyes (54%). Comparison of the serial photographs taken during the follow-up period using a red filter (600 nm, Wratten No. 25) showed progression of PE changes in 25 eyes (64%). In most eyes PE changes remained, however, mild. More pronounced PE atrophy developed in 10 eyes (26%), and a disciform lesion in 1 eye. The latest visual acuity was 0.5 or better in 35 eyes (90%).
Green, R. P., Jr., D. W. Carlson, et al. (1988). "Central serous chorioretinopathy in U.S. Air Force aviators: a review." Aviat Space Environ Med 59(12): 1170-5.
Idiopathic central serous chorioretinopathy (ICSC) is an uncommon disease with the potential to cause loss of visual acuity, decreased color vision, and decreased depth perception. These visual changes may become permanent and require removal of aviators from flight status. This study reviews 55 eyes of 47 USAF aviators with ICSC examined at the United States Air Force School of Aerospace Medicine (USAFSAM), Brooks AFB, TX. Clinical and aeromedical findings, both on initial and on follow-up ophthalmic examination were studied. Ninety-seven percent of aviators otherwise medically qualified were ultimately returned to flight status. Overall, 51% had recurrent episodes, 17% had bilateral disease, and 13% underwent laser photocoagulation. Visual acuity correlated with active disease, and there was a trend toward poor stereopsis and diminished color vision with worsening visual acuity. Eighty-six percent attained a final visual acuity of 20/20 or better. On final examination, 90% had normal stereopsis, 87% had normal color vision, and 49% had a normal central visual field. Eyes with recurrent disease tended to have degraded final visual acuity, stereopsis, color vision, and central visual field. The visual and aeromedical prognosis from a single attack of ICSC is generally favorable, but repeated attacks can lead to a significant decrease in visual functions that may jeopardize flying status.
Miyake, Y., N. Shiroyama, et al. (1988). "Local macular electroretinographic responses in idiopathic central serous chorioretinopathy." Am J Ophthalmol 106(5): 546-50.
Using focal stimuli to human macular regions, we recorded electroretinograms in 24 patients with central serous chorioretinopathy of recent onset (mean visual acuity, 20/20). The stimulus spot was 10 degrees in diameter. Intact fellow eyes served as controls. The local macular electroretinograms of the affected eyes were significantly reduced and the implicit time in each component was significantly prolonged. The mean (+/- S.D.) amplitudes, expressed as percentages of mean amplitudes recorded in fellow eyes, were 64.6% +/- 22.7% (a-wave), 49.6% +/- 21.0% (b-wave), and 15.0% +/- 21.6% (oscillatory potentials). Two to five months after the macular detachment resolved, recordings in 18 patients showed remarkable recovery of a- and b-waves and shortened implicit times. However, the oscillatory potentials showed significantly small recovery in amplitude. Since oscillatory potentials and b-waves were significantly more deteriorated than a-waves in the presence of macular detachment, and oscillatory potentials showed selective delay of recovery in the convalescent stage, central serous chorioretinopathy may involve functional disturbances in the inner retinal layer as well as the photoreceptors.
Roseman, R. L. and R. J. Olk (1988). "Grid laser photocoagulation for atypical central serous chorioretinopathy." Ophthalmic Surg 19(11): 786-91.
A 30-year-old man had symptoms and signs consistent with bilateral classic central serous chorioretinopathy. Conventional single-session laser treatments to both eyes stabilized the condition for 9 years. The patient then developed atypical central serous chorioretinopathy consisting of tracts of fluid emanating from the posterior pole and bilateral inferior exudative retinal detachments. Diffuse retinal pigment epithelial disease with recurrent leakage in both maculas was treated with grid laser photocoagulation, which was effective in stabilizing the patient's condition.
Ficker, L., G. Vafidis, et al. (1988). "Long-term follow-up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy." Br J Ophthalmol 72(11): 829-34.
In a prospective randomised trial of argon laser photocoagulation in the management of central serous retinopathy, long-term follow-up (6.4 to 12.1 years) revealed no evidence that treatment significantly influenced the visual outcome as measured by the Snellen chart and by the Farnsworth-Munsell 100-hue test. Treatment did not reduce either the recurrence rate or the prevalence of chronic disease. Complications of treatment were uncommon. The justification for argon laser photocoagulation appears to be limited to the hastening of symptomatic relief by earlier resolution of serous detachment.
Schatz, H. (1988). "Central serous chorioretinopathy--the etiology of sequelae." Ophthalmology 95(7): 1007-8.
Poletti, J., A. Poletti, et al. (1988). "[Treatment by acupuncture of central serous chorioretinopathy]." Bull Soc Ophtalmol Fr 88(6-7): 917-9.
Beuchat, L., F. Simona, et al. (1988). "[Abnormalities of retinal function (light sense) following idiopathic central serous chorioretinopathy and diffuse retinal epitheliopathy]." Klin Monatsbl Augenheilkd 192(5): 471-4.
Although central serous retinopathy is considered a "benign" condition, it is associated in healed forms with frequent and troublesome impairment of visual function. The abnormalities are even more severe after diffuse retinal pigment epitheliopathy. Since Snellen visual acuity testing is a relatively imprecise index of visual function, it does not enable the subtle visual disturbances experienced by these patients to be fully appreciated. The authors evaluated visual function disorders by static automated perimetry and contrast sensitivity in 30 patients with healed central serous retinopathy and in five patients with diffuse epitheliopathy at a cicatricial stage. The results of this study are examined and discussed.
Turut, P., D. Malthieu, et al. (1988). "[Central serous chorioretinopathy and subretinal neovessels: overdose or indication of an error in the laser treatment]." Bull Soc Ophtalmol Fr 88(5): 635-6.
Poletti, J., A. Poletti, et al. (1988). "[Treatment by acupuncture of central serous chorioretinopathy]." Bull Soc Ophtalmol Fr 88(4): 573-4, 577.
Akiyama, K., M. Kawamura, et al. (1987). "Retinal vascular loss in idiopathic central serous chorioretinopathy with bullous retinal detachment." Ophthalmology 94(12): 1605-9.
Three patients with idiopathic central serous chorioretinopathy (ICSC) and bullous retinal detachment (RD) were examined at least 2 years after the onset of the disease in one patient and over 10 years in the other two patients. There were large areas of retinal pigment epithelium (RPE) degeneration in each patient. Interestingly, there was loss of retinal vascular trees in the inferior peripheral retina where the subretinal fluid presumably persisted for a long time. In one patient, there was a retinal neovascularization with sea-fan formation along the border of the vascular loss. To the authors' knowledge, this finding has not been described in the literature.
Lambert, S. J. and R. B. Pinkert (1987). "The simultaneous presentation of retinopathy of prematurity and central serous chorioretinopathy." J Am Optom Assoc 58(11): 902-6.
A case report of central serous chorioretinopathy (CSC) and retinopathy of prematurity (ROP) in the same patient is presented. CSC is a disease of the outer retinal layers, specifically the retinal pigment epithelium, which results in serous detachment of the neurosensory retina. ROP is a disease of the anterior retinal layers, affecting the retinal vasculature. Ocular manifestations may range from the peripheral neovascularization observed in the milder states to retinal detachment and secondary angle closure glaucoma that is often found in the later stages. Therefore it would appear that there is no direct relationship between the presence of ROP and the presence of CSC in a patient who presented with complaints of a unilateral relative central scotoma. To our knowledge this represents a heretofore unreported association.
Liu, C. Z. (1987). "[Fluorescein angiography follow-up of central serous chorioretinopathy]." Zhonghua Yan Ke Za Zhi 23(6): 323-5, 24.
Lu, J. G. and T. R. Friberg (1987). "Idiopathic central serous retinopathy in China: a report of 600 cases (624 eyes) treated by acupuncture." Ophthalmic Surg 18(8): 608-11.
Six hundred Chinese patients (624 eyes) with clinically diagnosed central serous retinopathy were treated by consecutive courses of acupuncture. Eighty-six percent of patients had resolution of their subretinal fluid within 3 months of treatment, a result similar to the natural history of the disease as reported by others in non-Chinese patients. Central serous retinopathy was most common in the 30 to 50 year age group, occurred in males seven times more frequently than in females, and was bilateral in 4% of patients.
Gartner, J. (1987). "Long-term follow-up of an ophthalmologist's central serous retinopathy, photocoagulated by sungazing." Doc Ophthalmol 66(1): 19-33.
The author describes his own unilateral multifocal and recurrent central serous retinopathy (CRS). After 71 recurrences during the first 19 years, he photocoagulated the diseased macula three times by sungazing. There were no more recurrences after photocoagulation treatment during the last 10 years. Fluorescence angiography was performed 10 days before and 14 days after the first photocoagulation. At the time of the postoperative angiography, vision was restored from 0.5 to 1.2. The angiogram shows a hyperfluoresence of the "inkblot" type in the centre of the clinical macula, giving evidence that sungazing had produced a focal lesion of the retinal pigment epithelium. The absorption of a macular edema after creation of a "leak" by sungazing can be explained by the hypothesis (Marmor) that most "leaks" do not cause subretinal fluid but represent diffusion of fluorescein down a concentration gradient into the subretinal fluid. In addition to the treatment with solar photocoagulation, vitamin E was taken during the last 11 years. At present, 32 years after the onset of the disease, there is an extensive depigmentation of the macula. Visual acuity is 1.0.
Mackowiakowa, A., K. Pecoldowa, et al. (1987). "[Comparison of late results of conservative treatment and laser coagulation of central serous chorioretinopathy]." Klin Oczna 89(4): 162-4.
Xin, D. Y., L. Z. Wu, et al. (1987). "[Visual evoked potential (VEP) abnormality in central serous choroid-retinopathy during the active stage]." Yan Ke Xue Bao 3(1): 28-31.
Yang, S. M. and G. Chen (1987). "[Single binocular vision of central serous choroid-retinopathy]." Yan Ke Xue Bao 3(1): 25-7.
Gelber, G. S. and H. Schatz (1987). "Loss of vision due to central serous chorioretinopathy following psychological stress." Am J Psychiatry 144(1): 46-50.
The authors studied 33 patients with central serous chorioretinopathy and found that a very disturbing psychological event had preceded the loss of vision in 91% of the cases. The acute disturbance preceded the first visual symptoms by an average of 7 days. When relapses occurred, the psychological disturbances were often less severe and preceded the visual symptoms by minutes or hours. In some cases vision improved 1 to 2 weeks after the patient learned of the amelioration of the original distressing situation. The majority of the patients were found to be tension ridden, and 48% had cardiovascular abnormalities.
Spitznas, M. and J. Huke (1987). "Number, shape, and topography of leakage points in acute type I central serous retinopathy." Graefes Arch Clin Exp Ophthalmol 225(6): 437-40.
The evaluation of 430 consecutive eyes (87.5% from male, 12.5% from female patients) showed a leakage point with uniform dye spread in 93%. In 7%, a smoke-stack phenomenon was observed. The number of leakage points reached from 1 (71.6%) to 7 (0.2%). Most leakage points were found in a 1-mm-wide ring-shaped zone starting 0.5 mm from the center of the fovea. Beyond this zone the incidence dropped rapidly with the exception of the upper nasal quadrant. Of the leakage points, 33.2% were located in the upper nasal, 21.2% in the lower nasal, 19.0% in the upper temporal, and 14.8% in the lower temporal quadrant. Leakage points occurred more than 3 mm away from the center of the fovea in 11.8%. The papillomacular bundle contained 25.4% of the leakage points. Leakage points in recurrences were located within 1 mm of the primary leakage point in 80% of the cases.
Brancato, R., A. Scialdone, et al. (1987). "Eight-year follow-up of central serous chorioretinopathy with and without laser treatment." Graefes Arch Clin Exp Ophthalmol 225(3): 166-8.
A long-term retrospective study was conducted on two groups of patients affected with typical central serous chorioretinopathy (CSCR). One group was not treated and the other was treated by direct argon laser photocoagulation. CSCR shows a long-term good prognosis of visual acuity. The visual acuity of laser-treated eyes improves significantly (P less than or equal to 0.05), particularly in single focus cases (P less than or equal to 0.01). Unfortunately, these results cannot be statistically compared to the natural course of the non-treated patients because of the initial inhomogeneity of the two groups. Laser treatment did not produce any long-term complications. The recurrence rate in treated and untreated eyes was similar.
Karhan, J., Z. Smecka, et al. (1987). "[Treatment of central serous chorioretinopathy using green light from an argon laser]." Cesk Oftalmol 43(1): 12-6.
Chuang, E. L., D. M. Sharp, et al. (1987). "Retinal dysfunction in central serous retinopathy." Eye 1 ( Pt 1): 120-5.
Patients with acute and chronic central serous retinopathy (CSR) were studied by psychophysical and photochemical means to establish the extent of visual depression and to investigate the basis of rod dysfunction in this disorder. In acute disease with serous detachment of the retina, the loss of sensitivity attains 3 log units and parallels the height of retinal elevation as does its recovery with resolution of the episode. Immediately after resolution, there is a residual 0.5 log unit threshold elevation. In chronic disease, marked loss of function exists over areas of abnormal retinal pigment epithelium in the absence of clinically detectable serous detachment. Although rhodopsin levels are low in both acute and chronic CSR, this relative lack of visual pigment does not totally account for the functional deficits in either situation.
Sihota, R., R. V. Azad, et al. (1987). "Contralateral eye in central serous retinopathy." Indian J Ophthalmol 35(5-6): 327-9.
Novak, M. A., L. J. Singerman, et al. (1987). "Krypton and argon laser photocoagulation for central serous chorioretinopathy." Retina 7(3): 162-9.
Based on medical records, the authors divided 86 eyes of 84 patients with central serous chorioretinopathy with serous detachment of the macula and retinal pigment epithelial leakage on fluorescein angiography into three groups: no laser treatment (45 eyes), argon laser treatment (26 eyes), and krypton laser treatment (15 eyes). One or more episodes of recurrence developed during the follow-up period in 10 untreated eyes (22%), 9 argon-treated eyes (35%), and 0 krypton-treated eyes. The difference in recurrence rate between argon- and krypton-treated eyes was statistically significant. The findings suggest that whenever laser treatment is indicated, krypton red laser photocoagulation may reduce the incidence of recurrence in eyes with central serous chorioretinopathy.
Yannuzzi, L. A. (1987). "Type-A behavior and central serous chorioretinopathy." Retina 7(2): 111-31.
A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type A behavioral pattern based on the Jenkins Activity Survey. The patients selected as matched controls had painless, reduced central vision and other chorioretinal diseases (Group I), or non-chorioretinal ocular conditions (Group II). The Type A behavior was significantly more frequent in study patients than in either Control Group I (X2 = 6.1 and P less than 0.025) or Control Group II patients (X2 = 17.7 and P less than 0.001). When both control groups were combined for comparison to the CSP patients, there was also a highly significant difference with regard to Type A behavior (X2 = 14.1 and P less than 0.001). A comparison of Control Group I with Control Group II revealed no significant difference in Type A behavior. Subfactor analysis of the Type A behavior pattern was also studied. The results of this clinical study were used in conjunction with experimental evidence linking catecholamines with CSP in developing a multifactorial etiologic hypothesis. The hypothesis suggests that the eyes as an organ system, and the macula as an ultimate target area, can be intermittently or continuously stimulated adversely by Type A behavior and its physiological consequences, most notably a sympathetic discharge. The multifactorial concept alludes to other potential risk factors such as age, race, sex, refractive state, or unknown tissue susceptabilities. The pathogenesis implies an inter-relationship between finely balanced components of a complex biopsychological system involving an individual's genetic endowment, his environment, and his behavioral pattern. The concept also offers new possible lines of investigation for the treatment of CSP, utilizing pharmacological regulators and for its prevention through early identification of CSP-prone individuals. A review of the pertinent cardiovasculature literature linking the Type A behavior with coronary artery disease and the significant papers in the ophthalmic literature on central serous pigment epitheliopathy are included in the discussion.
Balogh, V. J. (1986). "The use of oral fluorescein angiography in idiopathic central serous choroidopathy." J Am Optom Assoc 57(12): 909-13.
A case report, differential diagnosis, and discussion of idiopathic central serous choroidopathy (ICSC) are presented. Procedures, advantages and disadvantages of oral and intravenous fluorescein angiography are discussed. Oral fluorography may be used to reliably diagnose ICSC and other late-staining disease processes.
Mazzuca, D. E. and W. E. Benson (1986). "Central serous retinopathy: variants." Surv Ophthalmol 31(3): 170-4.
Idiopathic central serous chorioretinopathy (ICSC) is a localized detachment of the sensory retina in the macula which is commonly seen by the general ophthalmologist. However, ICSC with bullous retinal detachment is a rare disease characterized by extensive sensory retinal detachment of the posterior pole and elsewhere. Thus far it has been reported in only nine Caucasian patients in the American literature. Two case reports are presented, one typifying ICSC, the other typifying ICSC with bullous retinal detachment. Although both entities probably share the same pathophysiologic mechanism, they are distinct in terms of diagnostic features and treatment. While ICSC is usually self-limiting and frequently diagnosed by history alone, ICSC with bullous retinal detachment is frequently misdiagnosed and subsequently treated improperly.
Robertson, D. M. (1986). "Argon laser photocoagulation treatment in central serous chorioretinopathy." Ophthalmology 93(7): 972-4.
Central serous chorioretinopathy, a sporadic self-limited disease of young adults, is associated with loss of central vision, image distortion, and imparied dark adaptation. The diagnosis is verified with fluorescein angiography, which demonstrates and expanding point of fluorescein dye leakage under a serous detachment of the sensory retina. Treatment should ordinarily be delayed four or more months but may be considered if there is evidence of microarchitectural changes in the macular retina, if the best corrected visual acuity declines to 20/40 or less, or if there have been multiple recurrences. Argon laser photocoagulation should be directed to the leakage site, using spot sizes of 200 mu in diameter, exposure times of 0.2 seconds, and low-power intensities.
Gross, M., P. Froom, et al. (1986). "Central serous retinopathy (choroidopathy) in pilots." Aviat Space Environ Med 57(5): 457-8.
The clinical charts of pilots in the Israeli Airforce were reviewed retrospectively for evidence of central serous retinopathy (CSR). There were 14 pilots with documented CSR identified, with an incidence of 1.3 per 1000 per year. Of 6 pilots who had recurrent attacks, 5 had a decrease of visual acuity during the initial attack to at least 20/30 in the affected eye. On the other hand, in those with visual acuity no worse than 20/25, only 1 of 7 had recurrent attacks (p less than 0.05). We conclude that CSR is a common condition in pilots, and that visual acuity during the initial attack can predict those who will have recurrent disease.
Langlois, M., G. Hochart, et al. (1986). "[Unusual aspects of vanishing points in central serous retinopathy associated with serous detachment of the pigment epithelium]." Bull Soc Ophtalmol Fr 86(4): 555-7.
Hayashi, K., Y. Hasegawa, et al. (1986). "Indocyanine green angiography of central serous chorioretinopathy." Int Ophthalmol 9(1): 37-41.
Indocyanine green angiograms of central serous chorioretinopathy in 30 eyes were evaluated in order to demonstrate the pathologic features of the retinal pigment epithelium. In 5 of the cases, the dye leakage or the pigment epithelial degeneration was seen to be associated with areas of choroidal circulatory insufficiency. This implies that local choroidal ischemia is one of the causes of the pigment epithelial disturbance.
Sherman, J., S. J. Bass, et al. (1986). "Visual evoked potential (VEP) delays in central serous choroidopathy." Invest Ophthalmol Vis Sci 27(2): 214-21.
The authors examined a series of ten consecutive patients with unilateral, idiopathic central serous choroidopathy. Visual acuities ranged from 20/20 to 20/70 during the active stage. VEPs were recorded to square sizes of 14, 28, and 56 min of arc. Overall, 90% of the patients had statistically significant VEP delays from the affected eye, while only 30% had statistically significant reductions in amplitude during the active stage. Six of the ten patients were reevaluated after the condition fully resolved. In all six, the VEP latency returned to normal. Although the mechanism of these VEP delays is not clear, their presence has been well documented. Therefore, a VEP delay in isolation of other tests should not be used in the differential diagnosis of macular vs optic nerve disease. One should specifically rule out macular disease in any patient with a delayed VEP before presuming the presence of a visual pathway dysfunction.
De Laey, J. J. (1986). "Central serous chorioretinopathy: to treat or not to treat?" Doc Ophthalmol 61(3-4): 367-72.
Deutman, A. F., F. Hendrikse, et al. (1986). "[Chronic serous central retinopathy]." Bull Mem Soc Fr Ophtalmol 97: 253-4.
Slusher, M. M. (1986). "Krypton red laser photocoagulation in selected cases of central serous chorioretinopathy." Retina 6(2): 81-4.
Krypton red laser photocoagulation was carried out in 15 eyes with chronic, uncomplicated monocular central serous chorioretinopathy. All patients had vocations requiring excellent binocular vision, and could not work effectively with their current visual acuity. Krypton red was selected as the most suitable photocoagulative source, given the nature of the disease, the tissue-selectiveness of krypton red laser on the retinal pigment epithelium, and the relative inability of the macular luteal pigment and capillary beds of the inner retinal layers to absorb the red wavelength. Visual acuity improved in all 15 eyes, and to at least 20/30 (6/9) in 12 eyes (80%). The visible effects of krypton red laser photocoagulation on the retinal pigment epithelium were minimal and, although nine eyes had had focal leaks within 100 microns of the foveal avascular zone and 12 eyes had been photocoagulated within the maculopapillar bundle, no adverse clinical effects were observed. In carefully selected cases, then, krypton red laser photocoagulation appears to be suitable and safe for the treatment of central serous chorioretinopathy in a tissue-specific manner.
Bhatti, S. K., S. D. Adrianwala, et al. (1986). "Xenon arc photocoagulation in the treatment of central serous retinopathy." J Postgrad Med 32(1): 37-8.
Spitznas, M. (1986). "Pathogenesis of central serous retinopathy: a new working hypothesis." Graefes Arch Clin Exp Ophthalmol 224(4): 321-4.
Yannuzzi, L. A. (1986). "Type A behavior and central serous chorioretinopathy." Trans Am Ophthalmol Soc 84: 799-845.
Ficker, L., G. Vafidis, et al. (1986). "Longterm results of treatment of central serous retinopathy--a preliminary report." Trans Ophthalmol Soc U K 105 ( Pt 4): 473-5.
The longterm follow-up of 38 patients with central serous retinopathy who were recruited into a prospective randomised trial of argon laser photocoagulation is reported. They were reviewed at a mean of 9.3 years after presentation. The results support the original findings that treatment shortens the disease, but does not benefit the final visual outcome.
Saraux, H., B. Pelosse, et al. (1986). "[Retrospective study of patients treated with the laser for central serous choroidopathies]." Bull Soc Belge Ophtalmol 220: 1-4.
Elhence, A. and C. Abraham (1986). "Results of argon laser photocoagulation in the treatment of central serous retinopathy." Indian J Ophthalmol 34: 254-8.
Tewari, H. K., R. Azad, et al. (1986). "Argon laser photocoagulation in treatment of central serous retinopathy--a prospective randomized study." Indian J Ophthalmol 34: 251-3.
Kaneko, E., M. Nawano, et al. (1985). "Ulcerative colitis complicated by idiopathic central serous chorioretinopathy with bullous retinal detachment." Dig Dis Sci 30(9): 896-900.
A 44-year-old woman, hospitalized with severe diarrhea due to ulcerative colitis, was found to have a rare ocular complication, idiopathic central serous chorioretinopathy with bullous retinal detachment. The ocular symptom started with the flare-up of the ulcerative colitis. Steroid therapy was not effective on the ocular disorder, while her ulcerative colitis became dormant. Relationship between the two disorders is discussed.
Harada, T. and K. Harada (1985). "Six cases of central serous choroidopathy induced by systemic corticosteroid therapy." Doc Ophthalmol 60(1): 37-44.
We report 6 cases of central serous choroidopathy (including pigment epithelial detachment in one case) which appeared in the course of systemic corticosteroid administration conducted to cure concurrent general diseases, and in one patient with a steroid-releasing pituitary adenoma. The majority of cases arose within about one month following the administration of more than 200 mg of prednisolon. It is postulated that corticosteroids operate as a kind of stress intervening in the hypophysis-adrenal system, leading eventually to the development of central serous choroidopathy.
Pahwa, V. (1985). "Optic pit and central serous detachment." Indian J Ophthalmol 33(3): 175-6.
Estruch Fajardo, I. M., C. H. Rodriguez Villalon, et al. (1985). "[Central serous choroiditis. Possible allergic etiopathogenesis] Preliminary report]." Allergol Immunopathol (Madr) 13(3): 249-57.
We performed a study of all patients with Central Serous Choroiditis that were attended in Ophthalmology consultation, both on ambulatory and emergency services, as well as in Allergy-Ophthalmology inter-consultations at the Provincial Educational Hospital "Saturnino Lora" in Santiago de Cuba, from January 1982 until July 1984. These patients were divided in two groups: A and B; the former was treated with suppression and challenge diets, and with antihistaminic drugs: the latter with conventional therapeutic agents. We established several criteria for the evaluation of results as: Good, Fair and Bad. We followed a similar procedure in evaluating the inflammatory state of the eye fundus as Discreet, Moderate and Severe. With the first evaluation of treatment at 15 days, we observed greater improvement in patients from group A than with patients from group B.
Han, D. P., H. S. Thompson, et al. (1985). "Differentiation between recently resolved optic neuritis and central serous retinopathy. Use of tests of visual function." Arch Ophthalmol 103(3): 394-6.
A test battery was performed on 13 patients with resolved central serous retinopathy and on 13 patients with resolved optic neuritis to see whether the tests would help to distinguish between the two conditions. We found that the most useful discriminators were the relative afferent pupillary defect, followed by the visual evoked potential latency and the critical flicker frequency. The total error score on the Farnsworth-Munsell 100-Hue Test and the nature of the color vision defect were not helpful in separating the two diseases.
Coppeto, J. R. (1985). "Central serous retinopathy, the Farnsworth-Munsell 100-Hue Test, and prolactin." Arch Ophthalmol 103(3): 323, 325.
Kissel, C., D. Sirbat, et al. (1985). "[Atypical central serous chorioretinopathy: apropos of a case]." Bull Soc Ophtalmol Fr 85(1): 141-4.
Yannuzzi, L. A., J. L. Shakin, et al. (1984). "Peripheral retinal detachments and retinal pigment epithelial atrophic tracts secondary to central serous pigment epitheliopathy." Ophthalmology 91(12): 1554-72.
Twenty-five patients with central serous pigment epitheliopathy (CSP), also known as central serous chorioretinopathy, have been observed to have inferior hemispheric retinal pigment epithelial atrophic tracts, presumptive of antecedent retinal detachments. Five of these patients were noted to have clinically discernible, dependent peripheral retinal detachments. The clinical and fluorescein angiographic features of these patients are reviewed. Alterations in the retina, the retinal pigment epithelium (RPE) and the choroid are also described. They include the commonly associated manifestations of CSP such as RPE leaks and macular detachment as well as some newly recognized disturbances such as retinal capillary dilatation (telangiectasia), retinal capillary leakage, retinal lipid deposition, cystoid macular edema, choriocapillaris atrophy, choroidal neovascularization and disciform scarring.
Gilbert, C. M., S. L. Owens, et al. (1984). "Long-term follow-up of central serous chorioretinopathy." Br J Ophthalmol 68(11): 815-20.
The Wilmer Retinal Vascular Center's experience with central serous chorioretinopathy from 1970 to the end of 1979 was reviewed and compared with previous studies. Retrospective analysis of 73 patients seen at follow-up suggests no clinically significant effect of focal argon laser photocoagulation on final visual acuity or recurrence rate. Patients with initial visual acuity of 20/20 remained at that level, and patients with initial visual acuity of less than 20/30 gained, on average, two to three Snellen lines at follow-up. Approximately one-third of both untreated and treated patients had recurrence or presumed persistence during the follow-up period. With the inclusion of episodes that occurred before the first Wilmer Institute visit about half of each group had recurrence or presumed persistence. Recurrences were most often due to leakage from a site within one disc diameter of the original site of leakage.
Kitahara, K., R. Tamaki, et al. (1984). "[Rayleigh color matches in central serous chorioretinopathy]." Nippon Ganka Gakkai Zasshi 88(11): 1364-8.
Cassel, G. H., G. C. Brown, et al. (1984). "Central serous chorioretinopathy: a seasonal variation?" Br J Ophthalmol 68(10): 724-6.
A review of 345 consecutive cases of patients under the age of 40 years with central serous chorioretinopathy seen between 1969 and 1979 was performed in order to define temporal patterns of occurrence. The monthly distribution of cases significantly differed (p less than 0.01) from an expected random distribution. Although a statistical trend analysis failed to confirm a definite seasonal variation (p less than 0.01), an increased number of cases were seen in March and April.
Radian, A. B. and C. Mocanu (1984). "[Enzymatic treatment of central serous retinopathy]." Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 28(4): 299-300.
van Meel, G. J., V. C. Smith, et al. (1984). "Foveal densitometry in central serous choroidopathy." Am J Ophthalmol 98(3): 359-68.
We evaluated foveal cone photopigment kinetics by retinal densitometry in 14 patients (12 men and two women, ranging in age from 30 to 54 years) with central serous choroidopathy. At the initial examinations when 12 of the 14 patients showed active leaks, the measured two-way density of pigment was low and the time-course of regeneration was slow. At later examinations, we found low two-way densities with normal regeneration times in five patients without active leakage. Near normal two-way densities occurred only in three patients who had complete clinical recoveries.
Folk, J. C., H. S. Thompson, et al. (1984). "Visual function abnormalities in central serous retinopathy." Arch Ophthalmol 102(9): 1299-302.
Eighteen patients with central serous retinopathy (CSR) underwent a battery of visual function tests when first seen and after resolution of the subretinal fluid. Eyes with CSR had minimal relative afferent pupillary defects, reduced critical flicker-fusion thresholds, prolonged visual evoked potential (VEP) latencies, increased errors on the Farnsworth-Munsell 100-hue (FM 100) test, and depressed central visual fields (Octopus). The afferent pupillary defect and critical flicker-fusion thresholds were the first to improve after resolution of the subretinal fluid. Next in rate of improvement were the visual acuity, the VEP latency, and the FM 100 test results. The threshold of the central Octopus at fixation improved the slowest and was still abnormal during long-term follow-up, indicating a prolonged depression in the threshold of central field sensitivity after resolution of the CSR. Many of these abnormalities are also seen in patients with optic nerve disease.
Wakakura, M. and S. Ishikawa (1984). "Central serous chorioretinopathy complicating systemic corticosteroid treatment." Br J Ophthalmol 68(5): 329-31.
Central serous chorioretinopathy developed in 2 cases of retrobulbar neuritis during systemic treatment with corticosteroids. Fluorescein angiography confirmed leakage surrounded by central serous detachment of the retina. In one case the central serous chorioretinopathy recurred 3 times during 3 separate courses of treatment. Spontaneous recovery accompanied a reduction in steroid treatment to a low level. It is suggested that high dosage corticosteroids may damage the posterior blood-ocular barrier.
Yoshioka, H., Y. Katsume, et al. (1984). "[Studies on experimental central serous chorioretinopathy. Fluorescein angiography and histopathology during the course of spontaneous remission]." Nippon Ganka Gakkai Zasshi 88(5): 819-28.
Papakostopoulos, D., C. D. Hart, et al. (1984). "Combined electrophysiological assessment of the visual system in central serous retinopathy." Electroencephalogr Clin Neurophysiol 59(1): 77-80.
Six subjects suffering from idiopathic central serous retinopathy were examined during the acute phase using a battery of neurophysiological tests. The records (using skin electrodes) included the electro-oculogram (EOG), the white light electroretinogram (ERG) during various stages of dark and light adaptation, and the flash and pattern reversal visual evoked potentials. Results obtained from the affected eye were compared with those from the healthy eye. The values of the healthy eye were not significantly different from our normal control group. The EOGs of the affected eyes were not significantly different from those of the healthy eyes. The 'a' wave of the ERG during light adaptation was significantly (P less than 0.05) smaller in the affected eye. The amplitudes of the other components and the latencies of all components were not affected. The latency of the PR-VEP of the affected eye in all subjects was prolonged in comparison with the unaffected eye. In 3 subjects the latency was prolonged by more than 2 S.D.s compared with our control group. The amplitude of the PR-VEP in 5 of our 6 subjects was slightly but significantly (P less than 0.02) smaller in the affected eye. There was no correlation between amplitude and latency changes.
Frederick, A. R., Jr. (1984). "Multifocal and recurrent (serous) choroidopathy (MARC) syndrome: a new variety of idiopathic central serous choroidopathy." Doc Ophthalmol 56(3): 203-35.
Presented is a group of 110 patients with patches of granular atrophy of the retinal pigment epithelium which I believe represents a new subtype of idiopathic central serous choroidopathy (ICSC). It is designated as multifocal and recurrent (serous) choroidopathy (MARC) syndrome. Such patients are the 'older' ICSC patients and they usually have bilateral involvement which may show marked asymmetry. The history is seldom helpful in defining previous episodes of leaking. The fundus changes are thought to represent the sequelae of multiple, recurrent, or chronic choroidopathy in the form of serous detachments of the retinal pigment epithelium and/or neurosensory retina. Such detachments may not be present at the time of a single examination, and thus the fundus picture may be puzzling without an awareness of this syndrome which exhibits a wide spectrum of severity. Difficulties in detecting the low detachments and fluorescein leaking are emphasized. There is often a marked disparity between the ophthalmoscopic and the fluorescein angiographic pictures, and examination by the latter technique is urged. I do not believe this entity progresses to senile disciform disease, but can result in marked visual loss. If extrafoveal leaking is found in the presence of decreased acuity and a macular detachment, and if there is evidence of previous attacks, photocoagulation can effectively flatten the retina. I believe photocoagulation therapy under these conditions is justifiable.
Yoshioka, H., Y. Katsume, et al. (1984). "Experimental central serous chorioretinopathy. IV: Fluorescein angiography and electron microscopy during spontaneous healing process." Kurume Med J 31(2): 89-99.
Todor, G. A. (1984). "[Luminescent and dark disk symptom in central serous chorioretinopathy]." Oftalmol Zh(4): 222-3.
Binaghi, M., Y. Prevost, et al. (1984). "[Idiopathic central serous chorioretinopathy]." J Fr Ophtalmol 7(5): 419-36.
Knave, B., B. Tengroth, et al. (1984). "Age and sex distribution of some retinal macular diseases: senile and presenile macular degeneration and central serous retinitis." Acta Ophthalmol Suppl 161: 95-103.
The age and sex distribution of senile macular degeneration (SMD) was investigated at the Low Vision Clinic in Stockholm. SMD increased with age and was found to be more common among women than men. This difference was not due to the fact that women live longer than men or related to women consulting ophthalmologists more often than men because of visual handicap. The age and sex distribution of presenile macular degeneration ( PSMD ) and central serous retinitis (CSR) was investigated at the Department of Ophthalmology of Falun Hospital. Also PSMD increased with age and was found to be more common among women than men, even if the sex difference was not as clear as for SMD. CSR was found to be more frequent at younger ages and, contrary to SMD and PSMD , more common among men. The reasons for these sex differences in frequencies of SMD, PSMD and CSR are not known.
Fastenberg, D. M. and R. R. Ober (1983). "Central serous choroidopathy in pregnancy." Arch Ophthalmol 101(7): 1055-8.
Central serous choroidopathy is an infrequent complication of pregnancy. A serous detachment of the macula was seen in three women during the course of their normal pregnancy. All patients showed resolution of the macular serous detachment in the third trimester, with resultant retinal pigment epithelial mottling; symptoms resolved in all patients post partum. Laboratory testing was not beneficial in establishing the cause of this disorder.
Fuhrmeister, H. (1983). "[A long-term study of morphological and functional developments after central serous chorioretinitis]." Klin Monatsbl Augenheilkd 182(6): 549-51.
Of 163 patients suffering from central serous chorioretinopathy, 40 who had been treated by light coagulation and 40 who had been treated conservatively were selected at random. They were examined at intervals averaging 5.7 and 4.6 years respectively after the initial treatment. Central visual acuity, central visual fields and the fundus were examined. The central visual acuity of the light-coagulated patients was normal both after initial treatment as well as at re-examination. In contrast, only one-half of the conservatively treated patients had normal visual acuity following initial treatment. However, after an average of 4.6 years it was normal in 34 cases. Neither quantitatively nor qualitatively was there any significant difference in the functional defects of the central visual fields in the two groups. The incidence of degenerative central retinal changes - above all at the level of the pigment epithelium - was considerably higher in the conservatively treated group than in the light-coagulated one.
Kalsi, R. (1983). "Central serous retinopathy and choroiditis." Indian J Ophthalmol 31(3): 149-50.
Murthy, K. R. and Rajashree (1983). "Management of central serous retinopathy." Indian J Ophthalmol 31(3): 135-6.
Patnaik, B. (1983). "Pathophysiology of central serous retinopathy." Indian J Ophthalmol 31(3): 129-30.
Piermarocchi, S., R. Corradini, et al. (1983). "Correlation between retinal pigment epitheliitis and central serous chorioretinopathy." Ann Ophthalmol 15(5): 425-8.
A 37-year-old woman had sudden blurred vision in her right eye due to multifocal disturbances of the macular retinal pigment epithelium. Fluorescein angiography showed multiple pigment epithelial window defects with minimal late hyperfluorescence. The course of the disease, interpreted as retinal pigment epitheliitis, was complicated by a central serous chorioretinopathy. The possible relation between the two entities is discussed.
Robertson, D. M. and D. Ilstrup (1983). "Direct, indirect, and sham laser photocoagulation in the management of central serous chorioretinopathy." Am J Ophthalmol 95(4): 457-66.
The role of argon laser photocoagulation in the management of central serous choriorectinopathy was evaluated in a prospective randomized study of eyes with leaks smaller than 250 microns in diameter in the early frames of the angiogram. Eyes were assigned to Group A when the leak was located in the papillomacular bundle or within 500 microns of the capillary-free zone and to Group B when the leakage site was located outside the papillomacular bundle and more than 500 microns from the capillary-free zone. Thirty eyes in Group A underwent either a sham argon laser treatment or a real argon laser treatment directed to the pigment epithelium under the elevated retina at a site remote from the site of fluorescein dye leakage (indirect laser photocoagulation). Twelve eyes in Group B underwent either a laser treatment directed to the site of fluorescein dye leakage (direct laser photocoagulation) or indirect laser photocoagulation. Compared with indirect photocoagulation, direct laser photocoagulation shortened the duration of central serous chorioretinopathy by approximately two months, a statistically significant difference. When compared to sham treatment, indirect photocoagulation did not significantly alter the duration of central serous chorioretinopathy. During an 18-month interval, the recurrence rate in the eyes treated with sham and indirect laser photocoagulation was 34%, whereas no recurrences were observed in the eyes treated with direct photocoagulation. There were no complications from photocoagulation in any of the eyes.
Lamba, P. A. and R. Srinivasan (1983). "Central serous retinopathy in leprosy." Lepr India 55(2): 209-11.
The involvement of fundus is rare in leprosy. More so fundus lesions, if any, are not very well visualized because of anterior segment lesions and the pupillary adhesions. A case of central serous retinopathy is recorded in association with progressive lepra reaction (type II) in a case of leprosy.
Cohen, D., A. Gaudric, et al. (1983). "[Diffuse retinal epitheliopathy and central serous chorioretinopathy]." J Fr Ophtalmol 6(4): 339-49.
Follow-up examinations were conducted in 27 patients (51 eyes) affected by diffuse retinal pigment epitheliopathy (D.R.P.E.), over an average period of 37 months. This disease associates multiple subretinal foci of leakage resulting in retinal serous detachments (R.S.D.), often widespread alterations in retinal pigment epithelium, and frequent small serous detachments of retinal pigment epithelium. The course is chronic and recurrence of subretinal leakage is common. Involvement of macular pigment results in poor long-term visual prognosis. Features of these patients were compared with those of 138 patients affected by central serous choroidopathy (C.S.C.). Both D.R.E.P. and C.S.C. are more frequent in males, and demonstrate subretinal leakages and transient retinal serous detachments. Nevertheless, numerous data differentiate these two diseases, D.R.P.E. being detected at a later age (49 years) than C.S.C. (39 years). Bilaterality of the affection is more frequent in D.R.E.P. (88 p. cent) while serous detachment is less frequent in D.R.P.E. (31 p. cent) than in C.S.C. (82 p. cent). Small foci of subretinal leakage are present in both diseases but they are frequently multiple, scattered, extra-macular and mainly peripapillary in D.R.P.E.; they are chronic or recurrent and are present usually in an area of pigment epithelium depigmentation. These changes are often vertically oriented downwards towards the inferior periphery of the fundus. In D.R.P.E. there are frequently visual fields defects (70,5 p. cent) corresponding to the area of pigmentary involvement, dyschromatopsy (64 p. cent) and E.O.G. abnormalities (75 p. cent). D.R.P.E. and C.S.C. are two closely related diseases but they differ by the extent and diversity of the pigment epithelium lesions functional impairment, and visual prognosis. Photocoagulation of leaking spots resulting in macular detachment appears to be justified as in C.S.C. Long-term prognosis depends on the degree of extension of pigmentary changes into the macular area.
Harada, T., H. Ichikawa, et al. (1983). "[Four cases of so-called atypical central serous choroidopathy]." J Fr Ophtalmol 6(6-7): 571-9.
Four cases of atypical central serous choroidopathy are presented. Serous detachment of the neuro-epithelium associated with multiple yellowish exudates in the macular region was an initial change, and this was followed by peripheral detachment. This condition is considered to be an allied disorder to central serous choroidopathy, fluorescein angiography showing leakage points or detachment of the retinal pigment epithelium, and photocoagulation with Xenon or laser to these points leading to recovery in three of the four cases, though it appears to be closely related to posterior uveitis.
Gavura, V. V. (1983). "[Pathogenesis of lesions of the central nervous system in serous meningitis and meningoencephalitis of viral etiology (review)]." Zh Nevropatol Psikhiatr Im S S Korsakova 83(7): 1084-92.
Kayazawa, F. (1982). "Central serous choroidopathy with exudative retinal detachment." Ann Ophthalmol 14(11): 1035-42.
An exudative retinal detachment that may be a severe type of central serous choroidopathy (CSC) developed in ten patients. These patients were all middle-aged, all but one were men, and all had a tendency of bilateral involvement. The retinal detachment was associated with doughnut-shaped exudative flecks, and the shifting of subretinal fluid with head position was observed in some cases. Fluorescein angiography revealed wide-ranged retinal pigment epithelial disturbances and effusive dye leakages, especially descending leakage. Treatment with steroids and antibiotics was ineffective, and photocoagulation resolved these conditions rapidly, otherwise spontaneous improvement occurred. The final visual outcomes were variable, and in some cases permanent visual loss occurred.
Faschinger, C. and H. Brunner (1982). "[Visual field examinations using the Octopus computerized perimeter following laser therapy of central serous chorioretinitis (Wessing type I)]." Klin Monatsbl Augenheilkd 181(5): 376-8.
The authors examined 19 patients who were suffering from central serous chorioretinopathy were treated with argon laser beams with a special user-defined program of the Octopus computerized perimeter. Relative scotomata were found at a depth of between 4 and 10 decibels in 66 percent of the patients; they were seldom subjectively considered to be a disturbance.
Vodovozov, A. M. and S. M. Sverdlin (1982). "[Fundus oculi studies using transformed light in central serous chorioretinopathy]." Vestn Oftalmol(3): 34-6.
Cruysberg, J. R. and A. F. Deutman (1982). "Visual disturbances during pregnancy caused by central serous choroidopathy." Br J Ophthalmol 66(4): 240-1.
Three patients had during pregnancy visual disturbances caused by central serous choroidopathy. One of them had a central scotoma in her first and second pregnancy. The 2 other patients had a central scotoma in their first pregnancy. Symptoms disappeared spontaneously after delivery. Except for the ocular abnormalities the pregnancies were without complications. The complaints can be misinterpreted as pregnancy-related optic neuritis or compressive optic neuropathy, but careful biomicroscopy of the ocular fundus should avoid superfluous diagnostic and therapeutic measures.
Calugaru, M. (1982). "[Problems of differential diagnosis and treatment in serous central chorioretinopathy]." Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 26(2): 99-103.
Kayazawa, F., T. Yamamoto, et al. (1982). "Temporal contrast sensitivity in central serous choroidopathy." Ann Ophthalmol 14(3): 272-5.
Temporal contrast sensitivity (TCS), a function of foveal sensitivity to sinusoidally modulated stimuli, was measured in 35 patients with central serous choroidopathy. Attenuation of the sensitivity at high temporal frequency was observed even when visual acuity was not impaired. In patients whose visual acuity was impaired, attenuation of the sensitivity of middle and/or low frequency as well as at high frequency was observed. In many cases TCS recovered to various degrees as the condition improved, even when little recovery of visual acuity was observed.
Kraushar, M. F. and E. M. Miller (1982). "Central serous choroidopathy misdiagnosed as a manifestation of multiple sclerosis." Ann Ophthalmol 14(3): 215-8.
Visual loss secondary to macular disease can be differentiated from optic nerve lesions relatively easily in the office by simple and reliable noninvasive means. The diagnosis of a medically or surgically treatable lesion can obviate for the patient the often unnecessary anxiety and expense of more extensive studies.
Gertz, J. and E. Alexandridis (1982). "[Central serous choroidopathy with retinal detachment. Case report]." Fortschr Ophthalmol 79(4): 329-30.
Yoshioka, H. and Y. Katsume (1982). "[Studies on experimental central serous chorioretinopathy. A light and electron microscopy]." Nippon Ganka Gakkai Zasshi 86(8): 738-49.
Kayazawa, F., H. Miyatani, et al. (1982). "[A biotechnical consideration on smokestack dye leakage in central serous retinopathy]." Nippon Ganka Gakkai Zasshi 86(11): 1957-61.
Yoshioka, H. and Y. Katsume (1982). "Experimental central serous chorioretinopathy. III: ultrastructural findings." Jpn J Ophthalmol 26(4): 397-409.
Experimental central serous chorioretinopathy was produced in a cynomolgus monkey. The sites of the outer blood retinal barrier coinciding with the spots of fluorescein leakage as confirmed by fluorescein angiography were examined by light and electron microscopy. Degeneration of a few retinal pigment epithelial cells was found, suggesting that the leakage of fluorescein into the subretinal space resulted from the disruption of the outer blood retinal barrier due to degeneration of the retinal pigment epithelial cells. Loss of the diaphragms or defects of damaged endothelial cells were observed in the inner surface of the choriocapillaris underneath these degenerated pigment epithelial cells. The region of these endothelial cell defects was covered with fibrin-platelet clots, and further, a considerable amount of fibrin existed within the Bruch's membrane. It is, thus, suggested that abnormal hyperpermeability of the choriocapillaris plays an important role in the pathogenetic development of this disease. Moreover, the results obtained in this study demonstrate that regional reparation of degenerated retinal pigment epithelial cells at the sites of fluorescein leakage will be initiated by rapid migration of surrounding normal retinal pigment epithelial cells in this experimental model.
Yoshioka, H., Y. Katsume, et al. (1982). "Experimental central serous chorioretinopathy in monkey eyes: fluorescein angiographic findings." Ophthalmologica 185(3): 168-78.
In an adult Japanese monkey (Macaca fuscatus), intravenous injections of adrenalin were repeated daily: 0.125 mg/kg for 7 days and 0.375 mg/kg from the 11th day on. In a cynomolgus monkey (Macaca irus), daily injections were carried out with intravenous adrenalin (0.11 mg/kg for 12 days and a double dose from the 13th day on) and also with intramuscular prednisolone. After the 39th injection in the former and after the 32nd injection in the latter monkey, disciform serous retinal detachment was seen to occur in the posterior pole region, and fluorescein angiography revealed multiple dye leakage spots at the level of the retinal pigment epithelium. Sometimes these changes subsided, but on continuing injections, these changes recurred on new locations. Two types of fluorescein leakage spots were recognized, i.e. ink blot type with progressive simple enlargement with time and the mushroom or jet type showing these patterns during enlargement. No abnormality was found in the optic disc, retinal vessels or in the choroidal circulation. The fluorescein angiographic findings were in close resemblance with those seen in the human central serous chorioretinopathy. It was discussed that these fundus changes of the monkey eye produced by repeated adrenalin injections would serve as a good animal model of the human disease.
Matsuura, M. and F. Ando (1981). "[Stellate ganglion block therapy in central serous chorioretinopathy (author's transl)]." Nippon Ganka Gakkai Zasshi 85(9): 1485-91.
Blair, N. P., R. J. Brockhurst, et al. (1981). "Central serous choroidopathy in the Hallermann-Streiff Syndrome." Ann Ophthalmol 13(8): 987-90.
Central serous choroidopathy was observed in a young patient with the Hallermann-Streiff syndrome. Typical features of this syndrome include microphthalmos, proportionate dwarfism, dyscephaly with birdlike facies, dental abnormalities, and hypotrichosis. Exceptional aspects of this case include age of onset (11 years), high hyperopic refractive error (+ 13.00 sphere), and multiple recurrences caused by six separate documented leaks from the choroid. Fundus changes previously reported in the Hallermann-Streiff syndrome, interpreted as chorioretinal pigmentary changes, may have been secondary to previous undiagnosed central serous choroidopathy. Periodic ophthalmoscopy should be performed and may detect unrecognized episodes of central serous choroidopathy for which photocoagulation would be beneficial.
Yoshioka, H., Y. Katsume, et al. (1981). "Experimental central serous chorioretinopathy. II: Further clinical findings." Kurume Med J 28(3): 189-96.
Yoshioka, H., Y. Katsume, et al. (1981). "[Studies on experimental central serous chorioretinopathy. Fluorescein angiographic findings (author's transl)]." Nippon Ganka Gakkai Zasshi 85(7): 760-70.
Piccolino, F. C. (1981). "Central serous chorioretinopathy: some considerations on the pathogenesis." Ophthalmologica 182(4): 204-10.
The author discusses the role of the following three factors in the pathogenesis of central serous chorioretinopathy: intraocular tension, adhesion of the pigment epithelium and choroidal hydrostatic pressure. Some cases of central serous chorioretinopathy present the angiographic findings typical of retinal pigment epitheliitis, others show choroidal perfusion defects in the area of subretinal leakage. Both are to be considered as secondary forms and distinguished from the idiopathic disease.
Felhagen, K. H., G. R. Herrmann, et al. (1981). "[Diagnostic and treatment experience with central serous retinitis]." Vestn Oftalmol(1): 20-2.
Annesley, W. H., Jr., J. J. Augsburger, et al. (1981). "Ten year follow-up of photocoagulated central serous choroidopathy." Trans Am Ophthalmol Soc 79: 335-46.
Swinnen, M. C., M. Brihaye-Van Geertruyden, et al. (1981). "[Acute posterior placoid pigment epitheliopathy and central serous retinitis]." Bull Soc Belge Ophtalmol 198(2): 67-79.
Kayazawa, F. (1981). "A case of central serous choroidopathy with peripheral retinal detachment." Albrecht Von Graefes Arch Klin Exp Ophthalmol 215(3): 145-8.
A case of bilateral CSC is reported: a 36-year-old man, whose fluorogram showed a peculiar change of leak type, namely smokestack phenomenon to ink-blot, and then to descending type in succession. As the leak type changed to descending type, serous detachment of the macula extended to the inferior periphery, and shifting of subretinal fluid occurred.
de Jong, P. T. (1981). "Laser treatment of central serous chorioretinopathy, of pigment epithelial detachments and of subretinal neovascularizations in senile disciform macular degeneration." Bull Soc Belge Ophtalmol 197: 55-61.
Fine, S. L. and S. L. Owens (1980). "Central serous retinopathy in a 7-year-old girl." Am J Ophthalmol 90(6): 871-3.
A 7-year-old girl experienced sudden loss of central visual acuity in one eye. Ophthalmoscopy disclosed a serous detachment of the sensory retina, and fluorescein angiography showed many areas of focal dye leakage through the pigment epithelium. Visual acuity returned to 6/7.5 (20/25), and the subretinal fluid was reabsorbed completely over the next two months. To our knowledge, this is the youngest patient with central serous retinopathy ever described.
Natsikos, V. E. and J. C. Hart (1980). "Static perimetric and Amsler chart changes in patients with idiopathic central serous retinopathy." Acta Ophthalmol (Copenh) 58(6): 908-17.
Macular disturbances in patients with active idiopathic central serous retinopathy can be readily documented by performing Amsler charting or static perimetry, but, as uncertainty exists as to which examination technique is superior for detecting disturbances after a detachment has settled, a study was performed in which patients were investigated by the two methods during the acute, resolving and resolved stages of the disease. All of the patients assessed in the acute phase showed abnormal responses to both forms of examination, but after the oedema fluid absorbed 63% of cases retained abnormal static profiles whereas 81% recorded defects on Amsler charting. Disturbances of retinal function were most apparent on static perimetry testing if the meridian studied corresponded to that intersecting the site at which the focal breakdown of the choroidoretinal barrier had developed and the fovea. The incidence of retinal changes was found to be greater in patients where the oedema resolved slowly.
Prskavec, F. H., H. Freyler, et al. (1980). "[Laser therapy in central serous retinopathy (author's transl)]." Klin Monatsbl Augenheilkd 177(6): 672-6.
Within the last five years 42 patients presenting with central serous retinopathy underwent argon laser photocoagulation. Both the plan of treatment and the evaluation of therapeutic success were based on the fluorescein angiogram.
Natsikos, V. E. and J. C. Hart (1980). "Photostress recovery times in cases of central serous retinopathy." J R Soc Med 73(11): 793-7.
Carr, R. E. and K. G. Noble (1980). "Central serous chorioretinopathy (central serous retinopathy)." Ophthalmology 87(8): 841-6.
Calugaru, M. (1980). "[Problems in etiopathogenesis and positive diagnosis of serous central chorioretinopathy]." Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 24(2): 121-4.
Salacz, G., G. Imre, et al. (1980). "[Ophthalmodynomometry results in central serous retinopathy]." Klin Monatsbl Augenheilkd 176(2): 211-3.
In nine out of 15 eyes with central serous retinopathy verified by fluoroangiography raised Pm. ophth. values were found. The average value of deviations obtained in these 15 eyes was significantly higher than in 30 controls. A possible correlation between central serous retinopathyl and increased peripheral cerebral flow resistance is discussed.
Vodovozov, A. M. (1980). "[Diagnostic importance of the fundus oculi light reflexes in central serous chorioretinopathy]." Oftalmol Zh 35(4): 207-9.
Shershevskaia, S. F. and P. Tatarchenko (1980). "[Central serous chorioretinopathy in retrobulbar neuritis]." Oftalmol Zh 35(4): 205-7.
Shpak, N. I. and R. N. Chuiko (1980). "[Pathogenesis, etiology and treatment of central serous chorioretinopathy]." Oftalmol Zh 35(4): 199-201.
Lewis, M. L. (1980). "Coexisting central serous choroidopathy and retinitis pigmentosa." South Med J 73(1): 77-80.
A 30-year-old woman with funduscopic and electrophysiologic findings of retinitis pigmentosa had in addition several asymptomatic serous detachments of the retinal pigment epithelium. She later had a typical serous detachment of the sensory retina which was recurrent, and finally required argon laser therapy.
Balacco-Gabrieli, C., F. Asciano, et al. (1980). "[Central serous retinopathy. Etiopathogenetic and clinical considerations (author's transl)]." Ophthalmologica 181(5): 251-60.
Etiopathogenetic, clinical and therapeutic study of 24 patients affected with central serous retinopathy, hospitalized in the Ophthalmological Clinic of the University of Bari during the period 1977-1978. After reviewing the main pathogenetic theories on the disease and taking into consideration their own findings, which are also based on specific psychiatric tests, the authors conclude that central serous retinopathy probably has a psychoangiospastic etiopathogenesis.
Makabe, R. (1980). "[Fluorescein fundus angiography and laser coagulation in central serous chorioretinitis]." Klin Monatsbl Augenheilkd 176(1): 157-9.
100 cases of central serous chorioretinitis with fluorescein leakage treatment with and without argon laser coagulation was compared. Final visual acuity was significantly better, and the duration of disease shorter, in the 61 patients who underwent coagulation than in the 39 who did not. Laser coagulation was especially effective in the cases with leakage in the upper macular region.
Pukhlik, E. S., L. A. Linnik, et al. (1980). "[Laser therapy in central serous chorioretinopathy]." Oftalmol Zh 35(4): 201-5.
Pau, H. (1979). "[Central serous retinitis or chorioretinitis (retinopathy or chorioretinopathy) and central hemorrhagic chorioretinitis (juvenile disciform macular detachment; focal hemorrhagic chorioiditis, presumed histoplasmosis) (author's transl)]." Klin Monatsbl Augenheilkd 175(5): 634-40.
There are no clinical or etiological connections between central serous and central hemorrhagic chorioretinitis, Serous chorioretinitis is seen mostly in men; full visual acuity is regained in approx. 80% of all cases. It mainly affects subjects aged between 36 and 45. Hemorrhagic chorioretinitis affects both sexes to about the same extent and causes severe impairment of visual acuity. Both forms should be regarded as genuine inflammations (chorioretinitis centralis serosa, chorioretinitis centralis hemorrhagica), not as "pathies". Whereas the hemorrhagica disease is generally thought to be caused by inflammation, the serous form also often shows signs of inflammation such as varying leakages with inflammatory depigmentation and more frequently inflammatory protein increase (exudate) with precipitation on the posterior surface of the retina/anterior surface of the pigment epithelium.
Taillanter, N. and M. Bonnet (1979). "[Central serous pseudoretinopathies secondary to choroidal neovessels]." Bull Soc Ophtalmol Fr 79(11-12): 1057-60.
Watzke, R. C., T. C. Burton, et al. (1979). "Direct and indirect laser photocoagulation of central serous choroidopathy." Am J Ophthalmol 88(5): 914-8.
A 3 1/2-year prospective randomized clinical trial showed a definite superiority of direct argon laser photocoagulation to the fluorescein leaking site compared to indirect treatment away from the leak in patients with central serous choroidopathy. One patient in each treatment group developed a subretinal neovascular membrane after photocoagulation to the fluorescein leak. Moderate prolongation of the neurosensory detachment did not adversely influence the final visual acuity in the indirect treatment group. Although direct laser photocoagulation reduces the duration of central serous choroidopathy, there is a risk of producing subretinal neovascularization. The principles of risk vs benefit should be explained to all patients and treatment should be advised only for compelling reasons.
Leaver, P. and C. Williams (1979). "Argon laser photocoagulation in the treatment of central serous retinopathy." Br J Ophthalmol 63(10): 674-7.
In a prospective randomised trial of argon laser photocoagulation in the management of central serous retinopathy it was confirmed that this treatment hastens resolution of the serous detachment. No evidence was found to suggest that treatment influences the final visual outcome in eyes with initial visual acuity of 6/12 or better.
Muntenu, G. (1979). "[Etiopathogenetic considerations on central serous retinopathy]." Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 23(3): 193-6.
Pecora, J. L. (1979). "Ibuprofen in the treatment of macular edema and central serous chorioretinopathy." Ann Ophthalmol 11(3): 494-5.
Nadel, A. J., M. I. Turan, et al. (1979). "Central serous retinopathy. A generalized disease of the pigment epithelium." Mod Probl Ophthalmol 20: 76-88.
Among cases of central serous retinopathy, patients have been isolated with retinal pigment epithelial (RPE) and sensory retinal detachments. An analysis of 104 cases occurring during the period from 1972 to 1977 indicates that this disorder is frequently bilateral and that it is associated with different disturbances of the epithelial cell layer, i.e. foci of leakage, transmission defects and serous detachments. Based upon the angiographic studies in 76 cases, we propose the following classification for cental serous retinopathy: I. Unilateral Retinopathy. (A) Uniocular involvement: (1) with focal leakage but no other RPE changes; (2) with focal leakage and other RPE changes; (3) with focal leakage, RPE changes and an exudative retinal detachment. (B) Binocular involvement: (1) mild; (2) moderate; (3) severe (with an exudative retinal detachment in the affected eye). II. Bilateral Retinopathy. (A) Mild; (B) moderate, (C) severe (in association with bilateral exudative retinal detachments). This classification emphasizes the fact that central serous retinopathy, whatever its etiology, represents a generalized affectation of the pigment epithelium and should be construed as a potentially serious disorder requiring thorough evaluation and follow-up care.
Rogozina, R. D. and N. B. Shlopova (1979). "[Clinical aspects, seasonal manifestations and the problems of treating central serous choroidopathy]." Oftalmol Zh 34(4): 226-7.
Watzke, R. C. and T. C. Burton (1979). "Direct versus indirect photocoagulation treatment of idiopathic central serous choroidopathy. A controlled clinical study." Mod Probl Ophthalmol 20: 429-30.
Li, J. X. (1979). "[Treatment of central serous retinopathy with helium-neon laser in 115 cases (141 eyes)---a preliminary report (author's transl)]." Zhonghua Yan Ke Za Zhi 15(4): 258-60.
Guo, X. R. (1979). "[Treatment of central serous retinopathy with argon laser combined with fluorescein angiography (author's transl)]." Zhonghua Yan Ke Za Zhi 15(4): 254-7.
Zhang, Z. Y. (1979). "[Preliminary observations on therapeutic results in 80 cases (100 eyes) of central serous retinopathy treated with ultrasound (author's transl)]." Zhonghua Yan Ke Za Zhi 15(4): 250-3.
Wang, K. S. (1979). "[Preliminary report on argon laser treatment of central serous chorioretinopathy (author's transl)]." Zhonghua Yan Ke Za Zhi 15(3): 182-4.
Pecora, J. L. (1978). "Ibuprofen in the treatment of central serous chorioretinopathy." Ann Ophthalmol 10(11): 1481-3.
A search of the literature yielded only one other paper concerning the use of ibuprofen for ophthalmic purposes. Marsili and Conte 8 used ibuprofen on a total of 138 patients with a variety of problems, both surgical and nonsurgical. They found an excellent to good response in about three fourths of their patients. This series of patients did as well or better. Three of the 4 were significantly helped with ibuprofen, and were pleased with the results. The fourth patient quite obviously did better while taking ibuprofen than she did without medication, and her visual acuity remained about the same as during steroid therapy. However, the patient herself was not satisfied with the results. It is my conclusion that ibuprofen has merit in the treatment of central serous chorioretinopathy. The concerned ophthalmologist may find the use of ibuprofen preferable to steroids in view of the dangers when these drugs are used at high dosages or for prolonged periods.
Bertrams, J., M. Spitznas, et al. (1978). "Missing evidence for HLA antigen association with Eales' disease, chorioretinitis, central serous retinopathy, and malignant choroidal melanoma." Invest Ophthalmol Vis Sci 17(9): 918-20.
Patients with Eales' disease, chorioretinitis, central serous retinopathy, or malignant choroidal melanoma were tested for HLA antigen deviation. When corrected p values (pc) are used, the first three disorders did not show any significant deviation, whereas a significant increase of HLA-Aw32 (pc = 0.026) was found in the malignant melanoma group. For conclusive evidence the latter finding needs confirmation by analysis of a greater number of patients with this disorder.
Tsukahara, I. and M. Uyama (1978). "Central serous choroidopathy with bullous retinal detachment." Albrecht Von Graefes Arch Klin Exp Ophthalmol 206(3): 169-78.
We report here a new type of secondary retinal detachment that has never been clearly defined. The characteristic features of the disease are: (1) prevalence in middle-aged males, (2) bilateral involvement, (3) frequent existence of prodromal lesions that over long periods resemble central serous retinopathy, (4) in the evolution stage, appearance of multiple yellowish white exudative flecks of one-half to one disc in diameter at or near the posterior pole of the fundus, (5) fluorescein studies revealing pronounced leakage of dye from the choroid into the subretinal space at the sites of exudates, (6) retinal detachment of various degrees with shifting subretinal fluid and without tears, (7) no evidence of intraocular inflammation, (8) no filling abnormalities seen in the choroidal fluorescence, (9) no response to medical therapy, including steroids and antibiotics, (10) photocoagulation to leakage sites leading to rapid resolution of retinal detachment; otherwise, spontaneous healing of detachment occurring within about 7-9 months, leaving fibroblastic macular scars and marked visual loss, and (11) no evidence of systemic findings that may be of etiologic significance. From this characteristic clinical picture, the idea of a new clinical entity must be considered. Our findings in 35 eyes from 18 Japanese patients are discussed.
Werry, H. and C. Arends (1978). "[Investigation in patients with central serous retinopathy with the MMPI Saarbrucken (author's transl)]." Klin Monatsbl Augenheilkd 172(3): 363-70.
Patients with angiographically proven C.S.R. were investigated with the MMPI. They showed significantly higher scores on the hypochondria and hysteria-scale. The idea, that C.S.R. is an ocular psychosomatic disease is supported by the profile pattern, which shows an elevation of the "Neurotic Triad" with the characteristically depressed "Psychosomatic Valley".
Grange, J. D. and M. Heirieis (1978). "[Comparative topographic study of the lesions of central serous retinopathy. (Angiographic review of 169 records)]." Bull Soc Ophtalmol Fr 78(1): 17-9.
Badrinath, S. S. and S. H. Baig (1978). "Central serous chorioretinopathy." Indian J Ophthalmol 25(4): 17-20.
Valnickova, J. and J. John (1978). "[Experience with the treatment of central serous retinopathy: comparative study]." Cesk Oftalmol 34(1): 51-6.
De Laey, J. J. and R. Laender (1978). "Unusual aspects of central serous choroidopathy." Bull Soc Belge Ophtalmol 182: 57-73.
Smith, V. C., J. Pokorny, et al. (1978). "Color matching and Stiles-Crawford effect in central serous choroidopathy." Mod Probl Ophthalmol 19: 284-95.
Color matching and Stiles-Crawford effect measurement were performed in 3 patients with central serous choroidopathy, 2 normal and 1 deuteranomalous trichromats. The color matches in the affected eye of each patient were displaced to red and could be explained by the hypothesis that the visual photopigments are in reduced optical density due to receptor disorientation caused by serous elevation of the sensory retina. The Stiles-Crawford effects of the affected eyes was abnormal confirming the hypothesis of receptor disorientation. The type III color defect accompanied by pseudo-protanomaly ascribable to receptor disorientation as occurs in central serous choroidopathy may be differentiated from the type III defect without pseudo-protanomaly.
Kovacs, B. (1977). "Visual phenomena following light coagulation in central serous retinopathy (CSR)." Doc Ophthalmol 44(2): 445-53.
A report on three patients with illustrations of their visual anomalies following light coagulation for their CSR disease is presented. The correspondence of the phenomena illustrated with the ophthalmoscopically visible fundus changes prove their objective origin.
Bonamour, G., M. Bonnet, et al. (1977). "[Topographic study of angiographic lesions in central serous retinopathy (author's transl)]." Klin Monatsbl Augenheilkd 171(6): 862-6.
The 595 angiographic lesions observed in 233 eyes of 169 patients affected with central serous retinopathy have been classified upon their localization. 498 angiographic lesions (83.7 percent) are located within a three optic disc diameter area centered by the foveola. Among them 20 are located right behind the foveola, 113 are located in the upper temporal quadrant, 166 in the upper nasal quadrant and 85 in the lower temporal quadrant. The relative density of the angiographic lesions decreases from the center of the macula to the periphery. 97 angiographic lesions (16.3 percent) are located beyond the three optic disc diameter central area. 41.1 percent of the lesions are situated behind the macula or/and behind the papillo-macular bundle. Therefore only 58.9 percent of the angiographic lesions observed in central serous retinopathy can be treated without any risk by means of photocoagulation.
Landers, M. B., 3rd, H. E. Shaw, Jr., et al. (1977). "Argon laser treatment of central serous chorioretinopathy." Ann Ophthalmol 9(12): 1567-72.
Thirty patients (33 eyes) with central serous chorioretinopathy were treated with argon laser photocoagulation. Visual acuity improved in 28 eyes (85%) and remained the same in 5 (15%). In all cases symptomatic improvement occurred and final visual acuity was 20/30 or better. No complications resulted from treatment. In deciding when to treat, one must consider the duration of a given episode, degree of visual impairment, visual needs of the patient, and location of the leakage site. While argon laser therapy of central serous chorioretinopathy is effective and safe, inadvertent foveal photocoagulation and intraretinal macular absorption of argon laser energy are potential therapeutic hazards.
Godel, V., M. Blumenthal, et al. (1977). "Retrobulbar neuritis and central serous chorioretinopathy." J Pediatr Ophthalmol 14(5): 296-8.
Schatz, H., L. A. Yannuzzi, et al. (1977). "Subretinal neovascularization following argon laser photocoagulation treatment for central serous chorioretinopathy: complication or misdiagnosis?" Trans Am Acad Ophthalmol Otolaryngol 83(5): 893-906.
Nanjiani, M. (1977). "Long-term follow-up of central serous retinopathy." Trans Ophthalmol Soc U K 97(4): 656-61.
Faurschou, S., T. Rosenberg, et al. (1977). "Central serous retinopathy and presenile disciform exudative macular degeneration. Is there an aetiological relationship between these two exudative conditions of the macula?" Acta Ophthalmol (Copenh) 55(3): 515-24.
The clinical syndromes central serous retinopathy (RCS) and presenile exudative disciform macular degeneration (PEDMD) are well known, but the causes of the pathophysiological and pathoanatomical changes in the choriocapillaris, Bruch's membrane and pigment epithelium as predisposing factors are unknown. Apparently these two degenerative macular conditions are different. However, they possibly represent two manifestations of the same nosological entity, which is initially dominated by a subretinal exudation in the macular region. It is therefore also reasonable to consider that RCS can be part of, or an initial stage of PEDMD. In the present study these possibilities have been demonstrated by a follow-up examination, using among other things fluorescein angiography of a selective material of 20 patients with RCS. In addition, it is shown that RCS can be a more serious condition with regard to the central vision than is generally accepted.
Kornacki, B. and T. Kecik (1977). "[Fluorescein angiography and laser photocoagulation in central serous retinopathy (author's transl)]." Klin Oczna 47(6): 267-9.
Gass, J. D. (1977). "Photocoagulation treatment of idiopathic central serous choroidopathy." Trans Am Acad Ophthalmol Otolaryngol 83(3 Pt 1): 456-67.
Tardif, Y. and A. Rousseau (1977). "[Role of photocoagulation in central serous choroidopathy]." Can J Ophthalmol 12(2): 98-105.
We reviewed thirty-two cases of central serous choroidopathy and retained twenty-five for a twelve-month study of the natural history of this disease. The main conclusions are that the disease is benign and self-limited; it sometimes leaves sequelae such as subnormal visual acuity because of faveolar leak through Bruch's membrane; photocoagulation is useful only in a minority of cases.
Lyons, D. E. (1977). "Conservative management of central serous retinopathy." Trans Ophthalmol Soc U K 97(1): 214-6.
A study of 26 patients (thirty attacks) with central serous retinopathy was made in order to assess the results of conservative management, and the factors which might affect the incidence of residual symptoms. There were two groups, one given systemic steroids and one given no treatment. Comparison is made with two groups treated by laser coagulation and another given no treatment.
Katsnel'son, L. A. and T. I. Balishanskaia (1977). "[Fluorescein-agiographic diagnosis and treatment of central serous choriopathy]." Vestn Oftalmol(1): 62-4.
Norris, J. L. and G. W. Cleasby (1977). "Central serous retinopathy revisited." Trans Pac Coast Otoophthalmol Soc Annu Meet 58: 253-7.
Dellaporta, A. (1976). "Central serous retinopathy." Trans Am Ophthalmol Soc 74: 144-53.
Risse, J. F., S. Heid, et al. (1976). "[Extramacular central serous chorioretinopathy associated with supposed histoplasmic choroiditis (case report)]." Bull Soc Ophtalmol Fr 76(9-10): 851-3.
Constantinides, M. G., F. Madelain, et al. (1976). "[Juxta-papillary central serous choroiditis]." Bull Soc Ophtalmol Fr 76(3): 269.
Chanson, J. F. and M. Tsacopoulos (1976). "[Late sequelae of central serous chorioretinopathy. Angiographic aspects]." Ophthalmologica 172(2-3): 237-9.
Heyman, J. (1976). "A new technique for detection of early central serous retinopathy." J Am Optom Assoc 47(1): 57-8.
Ueno, S., M. Yoshida, et al. (1976). "[Improvement of visual acuity after light coagulation for central serous retinopathy (author's transl)]." Nippon Ganka Gakkai Zasshi 80(6): 303-9.
Kolin, J. and J. A. Oosterhuis (1975). "Retinal pigment epithelium dystrophy in central serous detachment of sensory epithelium." Doc Ophthalmol 39(1): 1-12.
The incidence of central serous neuro-epithelial detachment in the polulation living in the health district Prague-10 was found to be one in 22,000 inhabitants a year. The cases were classified into three types: A. Inkblot diffusion 60%; B. upward diffusion 25%; C. congregation type 15%. The site of leakage was usually in the upper part of the detached retina or slightly below the horizontal line. Relapses were observed in 16 out of 79 patients, 20%, usually stemming from the original leak. The average re-attachment time was 98 days. In 10% a chronic course led to extensive dystrophy of the pigment epithelium.
Lieb, W. and E. Schroder (1975). "[The etiology and therapy of central serous retinopathy of the macula lutea]." Med Welt 26(46): 2084-6.
Kaluzny, J., C. Szwarcowa, et al. (1975). "[Central serous choroidoretinopathy]." Klin Oczna 45(10-11): 1103-8.
Haas, P., G. Clergue, et al. (1975). "[Treatment of serous central chorio-retinopathy using an argon laser]." Arch Ophtalmol Rev Gen Ophtalmol 35(10): 715-24.
After a short survey of the symptoms of the serous central retinopathy, the authors describe its treatment by argon laser. Almost all their results have been good in so short a time that they think the best way to manage the disease is to photocoagulate the leakage point as soon as it is discovered. In this manner a long course will be prevented, which disables the patient and is not harmless for the retina.
Paulmann, H. and K. Heimann (1975). "[Contribution to the problem of central serous retinal detachment (author's transl)]." Klin Monatsbl Augenheilkd 167(2): 324-32.
We described extensive and multifocal serous detachment of the neuroretina in cases of Harada's disease, optic head pitting, coloboma of choroid and optic nerve-head and bullous retinal detachment (Gass). Peripapillary serous detachment occurred in an additional case after branch occlusion of central retinal artery. Systemic steroids were useful in Harada's disease. The other cases required photocoagulation or argon laser treatment. Bullous retinal detachment did not heal until a buckling procedure was performed. The serous detachment of the neuroretina is considered as an uniform tissue-reaction of choroid, pigmentepithelium and neuroretina. The pathogenesis for this is unknown.
Fukuchi, S., S. Itotagawa, et al. (1975). "[Photocoagulation for the central serous choroidopathy with a leaking site near the fovea centralis (author's transl)]." Nippon Ganka Gakkai Zasshi 79(4): 318-30.
Flament, J., J. F. Risse, et al. (1975). "[Bilateral central serous chorio-retinopathy, migratory on 1 side. Discussion of a case]." Bull Soc Ophtalmol Fr 75(4): 455-62.
Constantinides, G., F. Madelain, et al. (1975). "[Unusual clinical aspect of serous central choroiditis]." Bull Soc Ophtalmol Fr 75(3): 303-4.
Greite, J. H. and R. Birngruber (1975). "Low intensity argon laser coagulation in central serous retinopathy (csr)." Ophthalmologica 171(3): 214-43.
Mechanisms of light coagulation effects in RPE and detached retina are discussed. 25 cases of CSR are presented in which the leaking point in the RPE was coagulated with an argon laser coagulator, the exposure parameters being set to avoid a whitening of the retina. The results suggest that the retinal whitening and consequently retinal damage does not constitute a criterium for coagulation effectiveness in CSR.
Lutsker, L. S. (1975). "[Microwave therapy and drug electrophoresis in treatment of central serous chorioretinitis and toxoplasmosis]." Oftalmol Zh 30(4): 249-51.
Schatz, H. (1975). "Central serous chorioretinopathy and serous detachment of the retinal pigment epithelium." Int Ophthalmol Clin 15(1): 159-68.
Flament, J., J. F. Risse, et al. (1974). "[Indications, technics and results of the treatment of central serous chorioretinopathy by argon laser photocoagulation]." Bull Soc Ophtalmol Fr 74(11): 1091-101.
Moriyama, C. (1974). "[Central serous retinopathy and photocoagulation. "Scotomata in photocoagulation" (author's transl)]." Nippon Ganka Gakkai Zasshi 78(8): 738-47.
Bedrossian, R. H. (1974). "Letter: Central serous retinopathy and pregnancy." Am J Ophthalmol 78(1): 152.
Patnaik, B., R. Kalsi, et al. (1974). "Photocoagulation in central serous retinopathy." Indian J Ophthalmol 22(2): 6-10.
Heinrich, M. R. (1974). "[Central serous retinopathy and alpha-blockaders]." Bull Soc Ophtalmol Fr 74(5-6): 681-3.
Klein, M. L., E. M. Van Buskirk, et al. (1974). "Experience with nontreatment of central serous choroidopathy." Arch Ophthalmol 91(4): 247-50.
Watzke, R. C., T. C. Burton, et al. (1974). "Ruby laser photocoagulation therapy of central serous retinopathy. I. A controlled clinical study. II. Factors affecting prognosis." Trans Am Acad Ophthalmol Otolaryngol 78(2): OP205-11.
Chumbley, L. C. and R. N. Frank (1974). "Central serous retinopathy and pregnancy." Am J Ophthalmol 77(2): 158-60.
Bonnet, M., C. Pingault, et al. (1974). "[Is central serous retinopathy a unilateral and very limited disease of the pigmented epithelium?]." Bull Soc Ophtalmol Fr 74(2): 234-6.
Theodossiadis, G. and D. Tongos (1974). "Treatment of central serous retinopathy. A comparative study with and without light coagulation." Ophthalmologica 169(6): 416-31.
Berrocal, J. A. (1974). "Current worldwide management of central serous choroidopathy." Mod Probl Ophthalmol 12(0): 239-41.
Watzke, R. C., T. C. Burton, et al. (1974). "Ruby laser photocoagulation therapy of central serous retinopathy. A preliminary report." Mod Probl Ophthalmol 12(0): 242-6.
Annesley, W. H., Jr., W. S. Tasman, et al. (1974). "Retrospective evaluation of photocoagulation for idiopathic central serous chorioretinopathy." Mod Probl Ophthalmol 12(0): 234-8.
Urrets-Zavalia, A., Jr. (1973). "Recurrence of central serous choroidopathy after photocoagulation." Can J Ophthalmol 8(3): 404-7.
Kitahara, K. (1973). "[Study on the differential threshold of brightness of color light on central serous chorioretinitis]." Nippon Ganka Gakkai Zasshi 77(7): 662-8.
Chevaleraud, J. P., G. Santucci, et al. (1973). "[Functional course and electrophysiology of central serous chorioretinitis treated by argon laser]." Bull Soc Ophtalmol Fr 73(5): 649-53.
Wessing, A. (1973). "Changing concept of central serous retinopathy and its treatment." Trans Am Acad Ophthalmol Otolaryngol 77(3): OP275-80.
Gass, J. D. (1973). "Bullous retinal detachment. An unusual manifestation of idiopathic central serous choroidopathy." Am J Ophthalmol 75(5): 810-21.
Fujisawa, Y. (1972). "[Clinical studies on central serous chorioretinopathy by fluorescein fundus angiography. IV. Application of light coagulation and inquiry into the pathogenesis]." Nippon Ganka Gakkai Zasshi 76(12): 1646-52.
Dufour, D., G. Constantinides, et al. (1972). "[Unusual aspects of simultaneous bilateral central serous choroiditis]." Bull Soc Ophtalmol Fr 72(11): 1129-32.
Epstein, D. L., D. E. Shacklett, et al. (1972). "Idiopathic central serous retinopathy (choroidopathy) in flying personnel." Aerosp Med 43(11): 1251-6.
Keller, J. T. and K. A. Polse (1972). "Central serous retinopathy with transitory monocular hypermetropia--a case report." Am J Optom Arch Am Acad Optom 49(9): 793-6.
Fujisawa, Y. (1972). "[Clinical studies on central serous chorioretinopathy by fluorescein fundus angiography. 3. Statistical observation and stereophotogrametry by fluorescein fundus angiography]." Nippon Ganka Gakkai Zasshi 76(7): 433-40.
Roca, P. D. (1972). "Problem of central serous chorioretinopathy." Eye Ear Nose Throat Mon 51(3): 128-30.
Dufour, D., P. Razemon, et al. (1972). "[Developmental aspects in fluorography of central serous choroiditis]." Bull Soc Ophtalmol Fr 72(2): 261-4.
Hache, J. C., G. Constantinides, et al. (1972). "[Developmental aspects of central serous choroiditis. Functional aspects]." Bull Soc Ophtalmol Fr 72(2): 257-60.
Tsukahara, I., S. Fukuchi, et al. (1972). "[Photocoagulation of central serous choroidopathy]." Nippon Ganka Kiyo 23(1): 46-51.
Dodds, R., R. Hulsbus, et al. (1972). "Peripheral retinoschisis and central serous detachment." Mod Probl Ophthalmol 10: 229-35.
Saldan, I. R. (1972). "[Fluorescent angiography in central serous chorioretinitis]." Oftalmol Zh 27(3): 213-5.
Leuenberger, A. and A. Gasche (1972). "[Light coagulation for central serous retinopathy]." Ophthalmologica 165(3-4): 366-72.
Haut, M. J. (1972). "[Use of the laser in the treatment of certain macular diseases, especially central serous choroidopathy]." Bull Soc Ophtalmol Fr 72(1): 23-9.
Coscas, G. and J. P. Aubry (1972). "[Evolutive angiographic aspects of central serous chorioretinopathies]." Bull Mem Soc Fr Ophtalmol 85(0): 169-87.
Metge, P., G. E. Jayle, et al. (1972). "[Anatomic and functional correlations in central serous chorioretinopathies in a period of activity]." Bull Mem Soc Fr Ophtalmol 85(0): 251-68.
Lipowski, Z. J. and R. Z. Kiriakos (1971). "Psychosomatic aspects of central serous retinopathy. A review and case report." Psychosomatics 12(6): 398-401.
Bessiere, E. and D. Pesme (1971). "[Central serous chorioretinopathy. Functional, angiographic and ophthalmoscopic data]." Bull Soc Ophtalmol Fr 71(11): 989-91.
Tsukahara, I. (1971). "[Hemorrhagic detachment of the pigment epithelium (hematoma under the retinal pigment epithelium)--relationship with macula lutea hemorrhage and central serous choroidopathy (Masuda's type)]." Ganka 13(9): 832-6.
Kolin, J. (1971). "[Some newer data from the study of macular diseases (with special regard to central serous retinitis or central serous retnal ablation)]." Cesk Oftalmol 27(4): 230-7.
Fujisawa, Y. (1971). "[Studies on central serous retinopathy with stereoscopic fluorescent fundus photography]." Nippon Ganka Kiyo 22(3): 117-20.
Amalric, P., P. Gourinat, et al. (1971). "[Is central serous choroiditis sometimes hereditary?]." Bull Soc Ophtalmol Fr 71(2): 163-8.
Miyashita, S., M. Sakai, et al. (1971). "[Successful treatment of central serous retinopathy by tranexamic acid injection]." Nippon Ganka Gakkai Zasshi 75: 603-8.
Tobari, I. and K. Shimizu (1971). "[Fluorography and photocoagulation of central serous retinopathy. II]." Nippon Ganka Gakkai Zasshi 75: 596-602.
Tamura, O. and T. Mikawa (1971). "[A study of a focal electroretinogram in central serous retinopathy]." Nippon Ganka Gakkai Zasshi 75(8): 1902-7.
Bonamour, G. and P. A. Dorne (1971). "[Is there a "central serous choroiditis"?]." Arch Ophtalmol Rev Gen Ophtalmol 31(1): 5-14.
Suzuki, H. and M. Kunishi (1970). "[On the pre-clinical stage of central serous retinopathy observed with fluorescence fundus photography]." Nippon Ganka Kiyo 21(10): 681-9.
Nagata, M. and Y. Honda (1970). "[Studies on local electric response of the human retina. VI. Macular ERGs of a typical central serous retinopathy]." Nippon Ganka Gakkai Zasshi 74(8): 957-64.
Murthy, G. R. (1970). "Entodon therapy in central serous retinopathy." J All India Ophthalmol Soc 18(2): 75-7.
Uyama, M. and M. Okuma (1970). "[Photocoagulation of central serous retinopathy]." Nippon Ganka Kiyo 21(6): 454-74.
Kanagawa, M. and M. Matsubara (1970). "[Xenon light-exposure as a treatment of central serous retinopathy]." Nippon Ganka Kiyo 21(6): 451-3.
Coscas, G. and M. Legras (1970). "[Disorders of color vision in central serous chorio-retinopathies]." Arch Ophtalmol Rev Gen Ophtalmol 30(6-7): 491-6.
Yoshioka, H. and T. Sugita (1970). "[Fluorescein fundus photographic studies on the central serous retinopathy. IV. On the prognosis]." Nippon Ganka Gakkai Zasshi 74(3): 268-72.
Carra, G. (1969). "[Psychosomatic aspects of central serous chorio-retinitis]." Boll Ocul 48(12): 928-33.
Nakatani, H., M. Nakauchi, et al. (1969). "[Studies on effects of retrobulbarly administered adenosine-5'-monophosphate on serous central retinitis, retinal hemorrhage and commotio retinae]." Nippon Ganka Kiyo 20(12): 1183-90.
Caramazza, R., R. Meduri, et al. (1969). "[Changes in the tonal discriminatory capacity caused by ophthalmodynamometric compression in subjects with central serous retinopathy]." Riv Otoneurooftalmol 44(6): 523-39.
Yoshioka, H. (1969). "[Diagnosis of central serous retinopathy (Masuda type)]." Nippon Ganka Kiyo 20(11): 999-1002.
Ikui, H. (1969). "[Histological examination of central serous retinopathy]." Nippon Ganka Kiyo 20(11): 1035-43.
Hirose, I. (1969). "[Therapy of central serous retinopathy]." Nippon Ganka Kiyo 20(11): 1003-34.
Yoshioka, H., T. Sugita, et al. (1969). "[A study of central serous retinopathy by means of fluorescein fundus photography. 3. On the seesaw phenomenon of abnormal fluorescence]." Nippon Ganka Kiyo 20(9): 900-9.
Watanabe, C., S. Nakayama, et al. (1969). "[Clinical studies on central serous retinochoroiditis]." Nippon Ganka Gakkai Zasshi 73(9): 1448-67.
Eu-sen, V. O. (1969). "Central serous retinopathy: a preliminary report of 33 cases." Med J Malaya 24(1): 18-20.
Orzalesi, N. and A. Serra (1969). "[Further acquisitions in the pathogenesis and therapy of central serous retinopathy. Retinal fluorescence angiography and treatment with lasers]." Boll Ocul 48(7): 471-90.
Jack, M. K. (1969). "Central serous retinopathy with optic pit treated with photocoagulation." Am J Ophthalmol 67(4): 519-21.
Yoshioka, H., Y. Endo, et al. (1969). "[The study of central serous chorioretinopathy by fluorescein fundus angiography. (I)]." Nippon Ganka Gakkai Zasshi 73(3): 299-305.
Mitsui, Y., M. Matsubara, et al. (1969). "[Xenon light-exposure as a treatment of central serous retinopathy (a preliminary report)]." Nippon Ganka Kiyo 20(3): 291-4.
Watanabe, C., S. Yoshida, et al. (1969). "[Clinical investigations on central serous retinochoroiditis. 2. Relations between ophthalmoscopic and angiographic findings in the course of the disease]." Nippon Ganka Kiyo 20(3): 254-67.
Jablonski, J. (1969). "[Current opinions on the central serous retinitis (central angiospastic retinopathy)]." Klin Oczna 39(4): 605-9.
Vodovozov, A. M. (1969). "[Ophthalmochromoscopy in central serous chorioretinitis]." Oftalmol Zh 24(2): 101-3.
Bonnin, P. (1969). "[Fluorescein angiography. Central serous chorioretinitis and related diseases]." Bull Soc Ophtalmol Fr: Suppl:91-119.
Offret, G., G. Coscas, et al. (1969). "[Central serous chorioretinitis and photocoagulation]." Bull Mem Soc Fr Ophtalmol 82: 385-96.
Norholm, I. (1969). "Central serous retinitis. A follow-up study." Acta Ophthalmol (Copenh) 47(4): 890-9.
Yoshioka, H. and T. Sugita (1969). "Fluorescein fundus photographic studies on the central serous retinopathy. II. Fluorescein fundus photographic findings in the full course of this disease." Kurume Med J 16(1): 1-12.
Chiampo, L., E. Mammarella, et al. (1968). "[A new etiopathogenetic trend in angiospastic central serous retinopathy]." Ann Ottalmol Clin Ocul 94(12): 1561-6.
Chabot, J., J. Rougier-Houssin, et al. (1968). "[Comparison of results obtained from various macular exploratory methods in a condition following central serous retinitis]." Bull Soc Ophtalmol Fr 68(11): 925-33.
Anselmi, P. (1968). "[Chromatic sense in central serous retinopathy and its changes in connection with the stage of the disease and experimentally induced hypertension]." Ann Ottalmol Clin Ocul 94(10): 1275-94.
Haik, G. M., L. F. Perez, et al. (1968). "Central serous retinopathy. Consecutive development in daughter and mother." Am J Ophthalmol 65(4): 612-5.
Spalter, H. F. (1968). "Photocoagulation of central serous retinopathy. A preliminary report." Arch Ophthalmol 79(3): 247-53.
Peabody, R. R., H. C. Zweng, et al. (1968). "Treatment of persistent central serous retinopathy." Arch Ophthalmol 79(2): 166-9.
Gilson, M., M. Watillon, et al. (1968). "[Physiopathology and treatment of central serous retinopathy]." Bull Soc Belge Ophtalmol 150: 588-99.
Wessing, A. (1968). "[Therapy of serous central retinitis using light coagulation]." Ber Zusammenkunft Dtsch Ophthalmol Ges 68: 429-31.
Elenius, V. (1968). "Double-flash ERG in central serous retinopathy." Acta Ophthalmol (Copenh) 46(5): 976-9.
Krassnig, M. (1968). "[The serous epitympanic otitis media--a central problem of otology]." Monatsschr Ohrenheilkd Laryngorhinol 102(10): 563-8.
Godde-Jolly, D. and M. P. Bonnin (1968). "[Apropos of 2 cases of central serous choroiditis treated by photocoagulation of chorio-retinal lesions, at a distance from the macula, indicated by fluorography]." Bull Soc Ophtalmol Fr 68(1): 8-13.
Vedy, J. and M. Chovet (1967). "[Apropos of one case of central serous chorioditis observed in French Somililand]." Med Trop (Mars) 27(6): 657-62.
Okuni, H., S. Okajima, et al. (1967). "Studies on viral infections of the central nervous system, especially serous meningitis in the Osaka area." Med J Osaka Univ 17(3): 287-96.
Kohchi, Y. (1967). "[Dynamics of accommodation in central serous retinopathy]." Nippon Ganka Gakkai Zasshi 71(2): 79-91.
Nunomura, H. (1967). "[Static perimetry of central serous retinopathy]." Nippon Ganka Kiyo 18(1): 86-9.
Batra, D. V. and S. D. Paul (1967). "Macular illumination test in central serous retinopathy." Am J Ophthalmol 63(1): 146-9.
el-Shewy, T. M. (1967). "Central serous retinopathy in relation to amoebiasis." Bull Ophthalmol Soc Egypt 60(64): 115-9.
Okuni, H. (1966). "[Study of viral diseases of the central nervous system in the Osaka area, with special reference to serous meningitis]." Nippon Shonika Gakkai Zasshi 70(8): 761-72.
Shershevskaia, O. I. (1966). "[The clinical picture and diagnosis of central serous chorioretinitis]." Vestn Oftalmol 79(2): 55-60.
Fujisawa, Y. (1966). "[Clinical studies on retinal and choroidal lesions by flurescein fundus photography. 2. Investigations following the course of central serous retinopathy]." Nippon Ganka Gakkai Zasshi 70(2): 150-60.
Straatsma, B. R., R. A. Allen, et al. (1966). "Central serous retinopathy." Trans Pac Coast Otoophthalmol Soc Annu Meet 47: 107-27.
Spinelli, D., V. De Molfetta, et al. (1965). "[Central serous chorioretinitis. Studies on behavior of the central visual field under different degrees of light]." Ann Ottalmol Clin Ocul 91(10): 815-9.
De Molfetta, V., D. Spinelli, et al. (1965). "[Central serous chorioretinitis. Electroretinographic studies]." Ann Ottalmol Clin Ocul 91(10): 787-97.
Miglior, M., V. De Molfetta, et al. (1965). "[Central serous chorioretinitis. Possible etiologic relationship with toxoplasmosis]." Ann Ottalmol Clin Ocul 91(5): 307-13.
Zanen, J. and A. Meunier (1965). "[Color perception and absolute and chromatic thresholds in central serous retinopathy]." Bull Soc Belge Ophtalmol 140: 259-69.