Authors: Ferrara, Daniela C; Calucci, Daniela; Oréfice, Juliana; Magalhães, Érika P; Oréfice, Fernando; Costa, Rogerio A

Source: Expert Review of Ophthalmology, Volume 3, Number 5, October 2008 , pp. 553-565(13)

Publisher: Expert Reviews

Abstract:

Central serous chorioretinopathy manifests as idiopathic serous detachment of the neurosensory retina, occasionally associated with small retinal pigment epithelium detachments in the macular area. The actual pathobiological mechanisms are not completely understood, but a strong association with endogenous or exogenous hypercortisolism is presumed. Although the clinical presentation may vary widely, visual symptoms are generally mild, unspecific and transitory. In rare circumstances the condition can evolve to significant and permanent visual impairment related to severe manifestations, relapsing or chronic episodes and secondary complications. Symptoms tend to resolve spontaneously in 3-6 months, but recurrences are expected to occur in up to 50% of the cases. Ancillary examinations may assist the diagnosis and identification of associated complications. While focal leaks at the level of the retinal pigment epithelium are highlighted on fluorescein angiography, indocyanine green angiography reveals widespread fundus involvement with multiple regions of choroidal hyperpermeability. Several therapeutic approaches have been proposed in unfavorable (persistent central serous chorioretinopathy) cases. In this article the proposed physiopathological mechanisms are discussed, leading to new insights into the clinical diagnosis and multidisciplinary management of this somewhat paradoxal disease.

Keywords: central serous chorioretinopathy; choroidal hyperpermeability; fluorescein angiography; fundus autofluorescence; hypercortisolism; indocyanine green angiography; macula; retinal pigment epithelium

Document Type: Research article

DOI: http://dx.doi.org/10.1586/17469899.3.5.553

Affiliations: 1: Department of Ophthalmology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil

Publication date: 2008-10-01

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