Central Serous Chorioretinopathy (CSR, CSCR, cCSC)

🙋 Please note that we did choose to include some smaller trials on this page as large clinical trials in
this field are scarce. In this setting, smaller studies sometimes set the tone for practice patterns.

Photodynamic therapy for chronic central serous chorioretinopathy (2010) ⏩
n=82, average 12mo
Study Question: non‐randomized, multicentre, interventional case series of patients with chronic (>6mo) CSC  that were treated by conventional PDT. Full fluence subfoveal CNV protocol.
Study results: Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT.

Comparison of efficacy and safety between half-fluence and full-fluence photodynamic therapy for chronic central serous chorioretinopathy (2011) ⏩

n=67, 

Study question:  retrospective comparison study, half-fluence PDT VS conventional PDT for the treatment of chronic central serous chorioretinopathy.

Study results: Treatment success without recurrence was achieved in 94.1% treated with half-fluence PDT and 100% of conventional PDT. No difference in final best-corrected visual acuity. Choriocapillaris perfusion decrease quantified from post-PDT indocyanine green angiography was significantly more severe in the conventional PDT group and it showed a positive correlation with retinal thinning after PDT.

A randomized double-blind placebo-control pilot study of eplerenone for the treatment of central serous chorioretinopathy. ECSELSIOR Study (2018) ⏩

n=15, 2mo

Study question: prospective, double-blind pilot RCT. Chronic CSCR (>3 months) treated with eplerenone VS placebo. 

Study results: mean reduction in central retinal thickness 82.5 μm and a mean reduction in SRF of 87.5 in the eplerenone-treated eyes. Worsening of SRF (+36) and CRT (+35μm) in the placebo group. Significant improvement in BCVA in the eplerenone group from 20/50 to 20/43 with no change in BCVA in the placebo group.

Treatment of central serous chorioretinopathy with topical NSAIDs (2019) ⏩

n=27, 5w

Study question: retrospective review. Topical bromfenac or nepafena VS observation for new-onset CSR.

Study results: CMT reductions in the control group averaged 43.5 µm and 196.2 µm in the tx group.

Reductions of subretinal fluid volume were 11.1% in the control and 64.3% in the tx group. There was no statistical significance in visual acuity letter gain between the groups.

Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4 months: VICI study (2020) ⏩
n=114, 12mo

Study question:  randomised, double-blind. Treatment-naive CSR for 4 months or more treated with eplerenone VS placebo.

Study results: Eplerenone was not superior to placebo for improving BCVA in people with chronic CSCR after 12 months of treatment. Side effects profile was similar in both groups (Hyperkalemia) The authors concluded that "Ophthalmologists who currently prescribe eplerenone for CSCR should discontinue this practice". 

Eplerenone for the treatment of chronic central serous chorioretinopathy: 3-year clinical experience (2020) ⏩

n=100, 36mo

Study question: retrospective chart analysis of patients with chronic (>4mo) CSR treated with epleranon.

Study results: The rate of complete SRF resolution was 31% at 1yr, 28% at 2yr and 33% at 3yr. At final follow-up, LogMar VA change from baseline was +0.10 ± 0.24. Average change from baseline at final follow-up for central subfield thickness was −97 ± 140.6 µm. Anatomical improvement occurred primarily within the first year of tx.

Oral Treatment of Central Serous Chorioretinopathy Patients Using Propranolol Tablets (2020) ⏩

n=120, 9mo

Study question: Oral propranolol VS placebo for CSR.

Study results: Tx group had better BCVA (0.09 ± 0.01 VS 0.19 ± 0.03 logMAR in the placebo),  shorter remission time (1.9 VS 3.5 months), higher “success” rate (95.0% vs 78.3%) and  lower recurrence rate (5.3% VS 25.5%).

Efficacy of Topical Carbonic Anhydrase Inhibitors (CAI) in Reducing Duration of Chronic Central Serous Chorioretinopathy (2020) ⏩

n=33, 3mo

Study question: Prospective, nonrandomized, controlled intervention. CAI VS observation for CSR.

Study Results: Topical CAI had greater reduction in CMT (−145.6 µm vs −45.1 µm) and more of the tx group achieved complete resolution of SRF (77.8% vs. 40.0%). Final BCVA was comparable in both groups.

Photodynamic Therapy Versus Eplerenone: Treatment Trial for Chronic Central Serous Chorioretinopathy (SPECT) ⏩

n=107, 2yr

Study question: half-dose PDT VS oral eplerenone for CSR.

No results published, study data is on Clinicaltrials.gov.

See also the review "Oral medications for central serous chorioretinopathy: a literature review" (2020)  ⏩

Abbreviations used on this page:

BCVA - best corrected visual acuity

CAI - carbonic anhydrase inhibitor 

CSR - Central Serous Chorioretinopathy

CRT - central retinal thickness 

logarithm of the minimum angle of resolution - LogMar

mo - months

PDT - photodynamic therapy 
SRF - sub retinal fluid

VA - visual acuity

VS - versus

w - week, weeks
yr - year

tx - treatment

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🚧 This page is still under construction as we have many more papers to add, if you have any suggestions just send us a line using the "contact us" form at the bottom of the page