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Statement of the Professional Association of Ophthalmologists in Germany (BVA), the German Society of Ophthalmology (DOG) and the German Retina Society (RG) on central serous chorioretinopathy

Status 18 October 2021

Stellungnahme von BVA, DOG und RG zur Chorioretinopathia centralis serosa (CCS)

Stand 18. Oktober 2021

  • Leitlinien, Stellungnahmen und Empfehlungen
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A Leitlinien, Stellungnahmen und Empfehlungen to this article was published on 14 December 2021

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References

  1. Alkin Z, Osmanbasoglu OA, Ozkaya A, Karatas G, Yazici AT (2013) Topical nepafenac in treatment of acute central serous chorioretinopathy. Med Hypothesis Discov Innov Ophthalmol 2:96–101

    PubMed  PubMed Central  Google Scholar 

  2. Ayata A, Tatlipinar S, Kar T, Unal M, Ersanli D, Bilge AH (2009) Near-infrared and short-wavelength autofluorescence imaging in central serous chorioretinopathy. Br J Ophthalmol 93:79–82

    Article  CAS  PubMed  Google Scholar 

  3. Azad AD, Zhou M, Afshar AR, Bakri SJ, Pershing S (2021) Systemic corticosteroid use after central serous chorioretinopathy diagnosis. Ophthalmology 128:121–129

    Article  PubMed  Google Scholar 

  4. Bae SH, Heo JW, Kim C, Kim TW, Lee JY, Song SJ, Park TK, Moon SW, Chung H (2011) A randomized pilot study of low-fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy. Am J Ophthalmol 152:784–792.e2

    Article  CAS  PubMed  Google Scholar 

  5. Battaglia Parodi M, Da Pozzo S, Ravalico G (2003) Photodynamic therapy in chronic central serous chorioretinopathy. Retina 23:235–237

    Article  CAS  PubMed  Google Scholar 

  6. Bonini Filho MA, de Carlo TE, Ferrara D, Adhi M, Baumal CR, Witkin AJ, Reichel E, Duker JS, Waheed NK (2015) Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmol 133:899–906

    Article  PubMed  Google Scholar 

  7. Borrelli E, Sarraf D, Freund KB, Sadda SR (2018) OCT angiography and evaluation of the choroid and choroidal vascular disorders. Prog Retin Eye Res 67:30–55

    Article  PubMed  Google Scholar 

  8. Bousquet E, Beydoun T, Rothschild P‑R, Bergin C, Zhao M, Batista R, Brandely M‑L, Couraud B, Farman N, Gaudric A et al (2015) Spironolactone for nonresolving central serous chorioretinopathy. Retina 35:2505–2515

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Bousquet E, Bonnin S, Mrejen S, Krivosic V, Tadayoni R, Gaudric A (2018) Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Retina 38(3):629–638. https://doi.org/10.1097/IAE.0000000000001580

    Article  PubMed  Google Scholar 

  10. Bujarborua D (2001) Long-term follow-up of idiopathic central serous chorioretinopathy without laser. Acta Ophthalmol Scand 79:417–421

    Article  CAS  PubMed  Google Scholar 

  11. Bujarborua D, Chatterjee S, Choudhury A, Bori G, Sarma AK (2005) Fluorescein angiographic features of asymptomatic eyes in central serous chorioretinopathy. Retina 25:422–429

    Article  PubMed  Google Scholar 

  12. Bujarborua D, Nagpal PN, Deka M (2010) Smokestack leak in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 248:339–351

    Article  PubMed  Google Scholar 

  13. Caccavale A, Romanazzi F, Imparato M, Negri A, Morano A, Ferentini F (2010) Low-dose aspirin as treatment for central serous chorioretinopathy. Clin Ophthalmol 4:899–903

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Cakir B, Reich M, Lang S, Bühler A, Ehlken C, Grundel B, Stech M, Reichl S, Stahl A, Böhringer D et al (2019) OCT angiography of the choriocapillaris in central serous chorioretinopathy: a quantitative subgroup analysis. Ophthalmol Ther 8:75–86

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chan W‑M, Lam DSC, Lai TYY, Tam BSM, Liu DTL, Chan CKM (2003) Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol 87:1453–1458

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chan W‑M, Lai TYY, Lai RYK, Liu DTL, Lam DSC (2008) Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial. Ophthalmology 115:1756–1765

    Article  PubMed  Google Scholar 

  17. Chen S‑N, Hwang J‑F, Tseng L‑F, Lin C‑J (2008) Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage. Ophthalmology 115:2229–2234

    Article  PubMed  Google Scholar 

  18. Chen ZJ, Lu SY, Rong SS, Ho M, Ng DS‑C, Chen H, Gong B, Yam JC, Young AL, Brelen M et al (2021) Genetic associations of central serous chorioretinopathy: a systematic review and meta-analysis. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2021-318953

    Article  PubMed  Google Scholar 

  19. Cheng C‑K, Chang C‑K, Peng C‑H (2017) Comparison of photodynamic therapy using half-dose of verteporfin or half-fluence of laser light for the treatment of chronic central serous chorioretinopathy. Retina 37:325–333

    Article  CAS  PubMed  Google Scholar 

  20. Cheung CMG, Lee WK, Koizumi H, Dansingani K, Lai TYY, Freund KB (2019) Pachychoroid disease. Eye (Lond) 33:14–33

    Article  Google Scholar 

  21. Chong C‑F, Yang D, Pham TQ, Liu H (2012) A novel treatment of central serous chorioretinopathy with topical anti-inflammatory therapy. BMJ Case Rep 2012:bcr2012006970. https://doi.org/10.1136/bcr-2012-006970

    Article  PubMed  PubMed Central  Google Scholar 

  22. Chuang EL, Sharp DM, Fitzke FW, Kemp CM, Holden AL, Bird AC (1987) Retinal dysfunction in central serous retinopathy. Eye (Lond) 1(1):120–125

    Article  Google Scholar 

  23. Chung Y‑R, Seo EJ, Lew HM, Lee KH (2013) Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review. Eye (Lond) 27:1339–1346

    Article  CAS  Google Scholar 

  24. Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, Jaisser F, Behar-Cohen F (2015) Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 48:82–118. https://doi.org/10.1016/j.preteyeres.2015.05.003

    Article  CAS  PubMed  Google Scholar 

  25. Daruich A, Matet A, Marchionno L, De Azevedo J‑D, Ambresin A, Mantel I, Behar-Cohen F (2017) Acute central serous chorioretinopathy: factors influencing episode duration. Retina 37(10):1905–1915. https://doi.org/10.1097/IAE.0000000000001443

    Article  PubMed  PubMed Central  Google Scholar 

  26. Delori FC, Dorey CK, Staurenghi G, Arend O, Goger DG, Weiter JJ (1995) In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics. Invest Ophthalmol Vis Sci 36:718–729

    CAS  PubMed  Google Scholar 

  27. Desai UR, Alhalel AA, Campen TJ, Schiffman RM, Edwards PA, Jacobsen GR (2003) Central serous chorioretinopathy in African Americans. J Natl Med Assoc 95:553–559

    PubMed  PubMed Central  Google Scholar 

  28. van Dijk EHC, Fauser S, Breukink MB, Blanco-Garavito R, Groenewoud JMM, Keunen JEE, Peters PJH, Dijkman G, Souied EH, MacLaren RE et al (2018) Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy. Ophthalmology 125:1547–1555

    Article  PubMed  Google Scholar 

  29. Ficker L, Vafidis G, While A, Leaver P (1988) Long-term follow-up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol 72:829–834

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Fok ACT, Chan PPM, Lam DSC, Lai TYY (2011) Risk factors for recurrence of serous macular detachment in untreated patients with central serous chorioretinopathy. Ophthalmic Res 46:160–163

    Article  PubMed  Google Scholar 

  31. Forooghian F, Meleth AD, Cukras C, Chew EY, Wong WT, Meyerle CB (2011) Finasteride for chronic central serous chorioretinopathy. Retina 31:766–771

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. French DD, Margo CE (2010) Central serous chorioretinopathy and phosphodiesterase‑5 inhibitors: a case-control postmarketing surveillance study. Retina 30:271–274

    Article  PubMed  Google Scholar 

  33. Gäckle HC, Lang GE, Freissler KA, Lang GK (1998) Central serous chorioretinopathy. Clinical, fluorescein angiography and demographic aspects. Ophthalmologe 95:529–533

    Article  PubMed  Google Scholar 

  34. de Gasparo M, Joss U, Ramjoué HP, Whitebread SE, Haenni H, Schenkel L, Kraehenbuehl C, Biollaz M, Grob J, Schmidlin J (1987) Three new epoxy-spirolactone derivatives: characterization in vivo and in vitro. J Pharmacol Exp Ther 240:650–656

    PubMed  Google Scholar 

  35. Gass JD (1967) Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol 63:1–139

    Google Scholar 

  36. Gass JD, Little H (1995) Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy. Ophthalmology 102:737–747

    Article  CAS  PubMed  Google Scholar 

  37. Gilbert CM, Owens SL, Smith PD, Fine SL (1984) Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol 68:815–820

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Haimovici R, Rumelt S, Melby J (2003) Endocrine abnormalities in patients with central serous chorioretinopathy. Ophthalmology 110:698–703

    Article  PubMed  Google Scholar 

  39. Heinrich MR (1974) Central serous retinopathy and alpha-blockaders. Bull Soc Ophtalmol Fr 74:681–683

    CAS  PubMed  Google Scholar 

  40. Ho M, Lai FHP, Ng DSC, Iu LPL, Chen LJ, Mak ACY, Yip Y, Cheung C, Young AL, Brelen M (2021) Analysis of choriocapillaris perfusion and choroidal layer changes in patients with chronic central serous chorioretinopathy randomised to micropulse laser or photodynamic therapy. Br J Ophthalmol 105:555–560

    Article  PubMed  Google Scholar 

  41. Hu J, Qu J, Li M, Sun G, Piao Z, Liang Z, Yao Y, Sadda S, Zhao M (2021) Optical coherence tomography angiography-guided photodynamic therapy for acute central serous chorioretinopathy. Retina 41:189–198

    Article  CAS  PubMed  Google Scholar 

  42. Iacono P, Battaglia PM, Papayannis A, La Spina C, Varano M, Bandello F (2015) Acute central serous chorioretinopathy: a correlation study between fundus autofluorescence and spectral-domain OCT. Graefes Arch Clin Exp Ophthalmol 253:1889–1897

    Article  PubMed  Google Scholar 

  43. Iida T, Yannuzzi LA, Spaide RF, Borodoker N, Carvalho CA, Negrao S (2003) Cystoid macular degeneration in chronic central serous chorioretinopathy. Retina 23:1–7 (quiz 137–138)

    Article  PubMed  Google Scholar 

  44. Jain AK, Kaines A, Schwartz S (2010) Bilateral central serous chorioretinopathy resolving rapidly with treatment for obstructive sleep apnea. Graefes Arch Clin Exp Ophthalmol 248:1037–1039

    Article  PubMed  Google Scholar 

  45. de Jong EK, Breukink MB, Schellevis RL, Bakker B, Mohr JK, Fauser S, Keunen JEE, Hoyng CB, den Hollander AI, Boon CJF (2015) Chronic central serous chorioretinopathy is associated with genetic variants implicated in age-related macular degeneration. Ophthalmology 122:562–570

    Article  PubMed  Google Scholar 

  46. Katsimpris JM, Pournaras CJ, Sehgelmeble CW, Petropoulos IK (2007) Severe bilateral central serous chorioretinopathy in a black patient: 16 years follow-up. Graefes Arch Clin Exp Ophthalmol 245:460–463

    Article  PubMed  Google Scholar 

  47. Karakus SH, Basarir B, Pinarci EY, Kirandi EU, Demirok A (2013) Long-term results of half-dose photodynamic therapy for chronic central serous chorioretinopathy with contrast sensitivity changes. Eye 27(5):612–620. https://doi.org/10.1038/eye.2013.24

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Kim KS, Lee WK, Lee SB (2014) Half-dose photodynamic therapy targeting the leakage point on the fluorescein angiography in acute central serous chorioretinopathy: a pilot study. Am J Ophthalmol 157:366–373.e1

    Article  PubMed  Google Scholar 

  49. Kitaya N, Nagaoka T, Hikichi T, Sugawara R, Fukui K, Ishiko S, Yoshida A (2003) Features of abnormal choroidal circulation in central serous chorioretinopathy. Br J Ophthalmol 87:709–712

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP (2008) The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980–2002. Ophthalmology 115:169–173

    Article  PubMed  Google Scholar 

  51. Koss MJ, Beger I, Koch FH (2012) Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy. Eye (Lond) 26:307–314

    Article  CAS  Google Scholar 

  52. Kozak I, Oster SF, Cortes MA, Dowell D, Hartmann K, Kim JS, Freeman WR (2011) Clinical Evaluation and Treatment Accuracy in Diabetic Macular Edema Using Navigated Laser Photocoagulator NAVILAS. Ophthalmol 118(6):1119–1124. https://doi.org/10.1016/j.ophtha.2010.10.007

    Article  Google Scholar 

  53. Lai TYY, Staurenghi G, Lanzetta P, Holz FG, Melissa Liew SH, Desset-Brethes S, Staines H, Hykin PG, MINERVA study group (2018) Efficacy and safety of ranibizumab for the treatment of choroidal neovascularization due to uncommon cause: twelve-month results of the MINERVA study. Retina 38(8):1464–1477. https://doi.org/10.1097/IAE.0000000000001744

    Article  CAS  PubMed  Google Scholar 

  54. Lainscak M, Pelliccia F, Rosano G, Vitale C, Schiariti M, Greco C, Speziale G, Gaudio C (2015) Safety profile of mineralocorticoid receptor antagonists: spironolactone and eplerenone. Int J Cardiol 200:25–29

    Article  PubMed  Google Scholar 

  55. Lavinsky D, Sramek C, Wang J, Huie P, Dalal R, Mandel Y, Palanker D (2014) Subvisible retinal laser therapy: titration algorithm and tissue response. Retina 34:87–97

    Article  PubMed  Google Scholar 

  56. Leaver P, Williams C (1979) Argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol 63:674–677

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Lee H, Lee J, Chung H, Kim HC (2016) Baseline spectral domain optical coherence tomographic hyperreflective foci as a predictor of visual outcome and recurrence for central serous chorioretinopathy. Retina 36:1372–1380

    Article  CAS  PubMed  Google Scholar 

  58. Lim JI, Spee C, Hinton DR (2010) A comparison of hypoxia-inducible factor-alpha in surgically excised neovascular membranes of patients with diabetes compared with idiopathic epiretinal membranes in nondiabetic patients. Retina 30:1472–1478

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lipowski ZJ, Kiriakos RZ (1971) Psychosomatic aspects of central serous retinopathy. A review and case report. Psychosomatics 12:398–401

    Article  CAS  PubMed  Google Scholar 

  60. Liu B, Deng T, Zhang J (2016) Risk factors for central serous chorioretinopathy: a systematic review and meta-analysis. Retina 36:9–19

    Article  PubMed  CAS  Google Scholar 

  61. Lotery A, Sivaprasad S, O’Connell A, Harris RA, Culliford L, Ellis L, Cree A, Madhusudhan S, Behar-Cohen F, Chakravarthy U et al (2020) Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4 months (VICI): a randomised, double-blind, placebo-controlled trial. Lancet 395:294–303

    Article  CAS  PubMed  Google Scholar 

  62. Ma J, Meng N, Xu X, Zhou F, Qu Y (2014) System review and meta-analysis on photodynamic therapy in central serous chorioretinopathy. Acta Ophthalmol 92:e594–e601

    Article  CAS  PubMed  Google Scholar 

  63. Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF (2010) Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology 117:1792–1799

    Article  PubMed  Google Scholar 

  64. Matet A, Daruich A, Zola M, Behar-Cohen F (2018) Risk factors for recurrences of central serous chorioretinopathy. Retina 38(7):1403–1414. https://doi.org/10.1097/IAE.0000000000001729

    Article  PubMed  Google Scholar 

  65. Matsumoto H, Kishi S, Otani T, Sato T (2008) Elongation of photoreceptor outer segment in central serous chorioretinopathy. Am J Ophthalmol 145:162–168

    Article  PubMed  Google Scholar 

  66. Meyerle CB, Freund KB, Bhatnagar P, Shah V, Yannuzzi LA (2007) Ketoconazole in the treatment of chronic idiopathic central serous chorioretinopathy. Retina 27:943–946

    Article  PubMed  Google Scholar 

  67. Mohabati D, van Rijssen TJ, van Dijk EH, Luyten GP, Missotten TO, Hoyng CB, Yzer S, Boon CJ (2018) Clinical characteristics and long-term visual outcome of severe phenotypes of chronic central serous chorioretinopathy. Clin Ophthalmol 12:1061–1070

    Article  PubMed  PubMed Central  Google Scholar 

  68. Mohabati D, Hoyng CB, Yzer S, Boon CJF (2020a) Clinical characteristics and outcome of posterior cystoid macular degeneration in chronic central serous chorioretinopathy. Retina 40:1742–1750

    Article  CAS  PubMed  Google Scholar 

  69. Mohabati D, Boon CJF, Yzer S (2020b) Risk of recurrence and transition to chronic disease in acute central serous chorioretinopathy. Clin Ophthalmol 14:1165–1175

    Article  PubMed  PubMed Central  Google Scholar 

  70. Nicholson B, Noble J, Forooghian F, Meyerle C (2013) Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 58:103–126

    Article  PubMed  PubMed Central  Google Scholar 

  71. Nicholson BP, Atchison E, Idris AA, Bakri SJ (2018) Central serous chorioretinopathy and glucocorticoids: an update on evidence for association. Surv Ophthalmol 63(1):1–8. https://doi.org/10.1016/j.survophthal.2017.06.008

    Article  PubMed  Google Scholar 

  72. Nicolò M, Zoli D, Musolino M, Traverso CE (2012) Association between the efficacy of half-dose photodynamic therapy with indocyanine green angiography and optical coherence tomography findings in the treatment of central serous chorioretinopathy. Am J Ophthalmol 153:474–480.e1

    Article  PubMed  Google Scholar 

  73. Nielsen JS, Jampol LM (2011) Oral mifepristone for chronic central serous chorioretinopathy. Retina 31:1928–1936

    Article  CAS  PubMed  Google Scholar 

  74. O’Keefe JH, Abuissa H, Pitt B (2008) Eplerenone improves prognosis in postmyocardial infarction diabetic patients with heart failure: results from EPHESUS. Diabetes Obes Metab 10:492–497

    Article  PubMed  CAS  Google Scholar 

  75. Park D‑G, Jeong S, Noh D, Sagong M (2021) Optimal fluence rate of photodynamic therapy for chronic central serous chorioretinopathy. Br J Ophthalmol 105:844–849

    Article  PubMed  Google Scholar 

  76. Pauleikhoff L, Agostini H, Lange C (2021) Chorioretinopathia centralis serosa. Ophthalmologe 118:967–980. https://doi.org/10.1007/s00347-021-01376-7

    Article  PubMed  Google Scholar 

  77. Peiretti E, Ferrara DC, Caminiti G, Mura M, Hughes J (2015) Choroidal neovascularization in caucasian patients with longstanding central serous chorioretinopathy. Retina 35:1360–1367

    Article  PubMed  Google Scholar 

  78. Piccolino FC, De La Longrais RR, Manea M, Cicinelli S (2008) Posterior cystoid retinal degeneration in central serous chorioretinopathy. Retina 28:1008–1012

    Article  PubMed  Google Scholar 

  79. Pichi F, Carrai P, Ciardella A, Behar-Cohen F, Nucci P, Central Serous Chorioretinopathy Study Group (2017) Comparison of two mineralcorticosteroids receptor antagonists for the treatment of central serous chorioretinopathy. Int Ophthalmol 37(5):1115–1125

    Article  PubMed  Google Scholar 

  80. Pikkel J, Beiran I, Ophir A, Miller B (2002) Acetazolamide for central serous retinopathy. Ophthalmology 109:1723–1725

    Article  PubMed  Google Scholar 

  81. Pitt B, Bakris G, Ruilope LM, DiCarlo L, Mukherjee R, EPHESUS Investigators (2008) Serum potassium and clinical outcomes in the eplerenone post-acute myocardial infarction heart failure efficacy and survival study (EPHESUS). Circulation 118:1643–1650

    Article  CAS  PubMed  Google Scholar 

  82. Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM (2015) Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol 160:581–587.e1

    Article  PubMed  Google Scholar 

  83. Rabiolo A, Bandello F (2020) Eplerenone is not superior to placebo for chronic central serous chorioretinopathy. Lancet 395:252–253

    Article  PubMed  Google Scholar 

  84. Rahbani-Nobar MB, Javadzadeh A, Ghojazadeh L, Rafeey M, Ghorbanihaghjo A (2011) The effect of helicobacter pylori treatment on remission of idiopathic central serous chorioretinopathy. Mol Vis 17:99–103

    PubMed  PubMed Central  Google Scholar 

  85. Rahimy E, Pitcher JD, Hsu J, Adam MK, Shahlaee A, Samara WA, Vander JF, Kaiser RS, Chiang A, Spirn MJ et al (2018) A randomized double-blind placebo-control pilot study of eplerenone for the treatment of central serous chorioretinopathy (ECSELSIOR). Retina 38(5):962–969

    Article  PubMed  Google Scholar 

  86. Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S, Sanfilippo M, Russo A, Uva MG, Munno F et al (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149:307–315.e2

    Article  PubMed  Google Scholar 

  87. van Rijssen TJ, van Dijk EHC, Dijkman G, Boon CJF (2018) Clinical characteristics of chronic central serous chorioretinopathy patients with insufficient response to reduced-settings photodynamic therapy. Graefes Arch Clin Exp Ophthalmol 256:1395–1402

    Article  PubMed  PubMed Central  Google Scholar 

  88. van Rijssen TJ, van Dijk EHC, Yzer S, Ohno-Matsui K, Keunen JEE, Schlingemann RO, Sivaprasad S, Querques G, Downes SM, Fauser S et al (2019a) Central serous chorioretinopathy: towards an evidence-based treatment guideline. Prog Retin Eye Res 73:100770

    Article  PubMed  Google Scholar 

  89. van Rijssen TJ, van Dijk EHC, Scholz P, Breukink MB, Blanco-Garavito R, Souied EH, Keunen JEE, MacLaren RE, Querques G, Fauser S et al (2019b) Focal and diffuse chronic central serous chorioretinopathy treated with half-dose photodynamic therapy or subthreshold micropulse laser: PLACE trial report no. 3. Am J Ophthalmol 205:1–10

    Article  PubMed  Google Scholar 

  90. van Rijssen TJ, van Dijk EHC, Scholz P, Breukink MB, Dijkman G, Peters PJH, Tsonaka R, MacLaren RE, Downes SM, Fauser S et al (2020) Crossover to photodynamic therapy or micropulse laser after failure of primary treatment of chronic central serous chorioretinopathy: the REPLACE trial. Am J Ophthalmol 216:80–89

    Article  PubMed  Google Scholar 

  91. van Rijssen TJ, van Dijk EHC, Scholz P, Breukink MB, Dijkman G, Peters PJH, Tsonaka R, Keunen JEE, MacLaren RE, Hoyng CB et al (2021) Long-term follow-up of chronic central serous chorioretinopathy after successful treatment with photodynamic therapy or micropulse laser. Acta Ophthalmol. https://doi.org/10.1111/aos.14775

    Article  PubMed  PubMed Central  Google Scholar 

  92. Robertson DM, Ilstrup D (1983) Direct, indirect, and sham laser photocoagulation in the management of central serous chorioretinopathy. Am J Ophthalmol 95:457–466

    Article  CAS  PubMed  Google Scholar 

  93. Rouvas A, Stavrakas P, Theodossiadis PG, Stamatiou P, Milia M, Giannakaki E, Datseris I (2012) Long-term results of half-fluence photodynamic therapy for chronic central serous chorioretinopathy. Eur J Ophthalmol 22(3):417–422

    Article  PubMed  Google Scholar 

  94. Sacconi R, Baldin G, Carnevali A, Querques L, Rabiolo A, Marchini G, Bandello F, Querques G (2018) Response of central serous chorioretinopathy evaluated by multimodal retinal imaging. Eye (Lond) 32:734–742

    Article  CAS  Google Scholar 

  95. Sacconi R, Borrelli E, Querques G (2020) Eplerenone for chronic central serous chorioretinopathy. Lancet 396:1556

    Article  PubMed  Google Scholar 

  96. Sadda SR (2020) Lack of efficacy of eplerenone for treatment of active central serous chorioretinopathy. Eye (Lond) 34:1489–1490

    Article  Google Scholar 

  97. Salehi M, Wenick AS, Law HA, Evans JR, Gehlbach P (2015) Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database Syst Rev 12:CD11841

    Google Scholar 

  98. Scholz P, Altay L, Fauser S (2017) A review of subthreshold micropulse laser for treatment of macular disorders. Adv Ther 34:1528–1555

    Article  PubMed  PubMed Central  Google Scholar 

  99. Schubert C, Pryds A, Zeng S, Xie Y, Freund KB, Spaide RF, Merriam JC, Barbazetto I, Slakter JS, Chang S et al (2014) Cadherin 5 is regulated by corticosteroids and associated with central serous chorioretinopathy. Hum Mutat 35:859–867

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Schwartz R, Habot-Wilner Z, Martinez MR, Nutman A, Goldenberg D, Cohen S, Shulman S, Guzner-Gur H, Loewenstein A, Goldstein M (2017) Eplerenone for chronic central serous chorioretinopathy—a randomized controlled prospective study. Acta Ophthalmol 95(7):e610–e618. https://doi.org/10.1111/aos.13491

    Article  CAS  PubMed  Google Scholar 

  101. Senturk F, Karacorlu M, Ozdemir H, Karacorlu SA, Uysal O (2011) Microperimetric changes after photodynamic therapy for central serous chorioretinopathy. Am J Ophthalmol 151:303–309.e1

    Article  PubMed  Google Scholar 

  102. Sharma T, Shah N, Rao M, Gopal L, Shanmugam MP, Gopalakrishnan M, Bhende P, Bhende M, Shetty NS, Baluswamy S (2004) Visual outcome after discontinuation of corticosteroids in atypical severe central serous chorioretinopathy. Ophthalmology 111:1708–1714

    Article  PubMed  Google Scholar 

  103. Shin MC, Lim JW (2011) Concentration of cytokines in the aqueous humor of patients with central serous chorioretinopathy. Retina 31:1937–1943

    Article  CAS  PubMed  Google Scholar 

  104. Shinojima A, Hirose T, Mori R, Kawamura A, Yuzawa M (2010) Morphologic findings in acute central serous chorioretinopathy using spectral domain-optical coherence tomography with simultaneous angiography. Retina 30:193–202

    Article  PubMed  Google Scholar 

  105. Shinojima A, Sawa M, Sekiryu T, Oshima Y, Mori R, Hara C, Sugano Y, Kato A, Asato H, Yuzawa M et al (2017) A multicenter randomized controlled study of antioxidant supplementation with lutein for chronic central serous chorioretinopathy. Ophthalmologica 237:159–166. https://doi.org/10.1159/000455807

    Article  CAS  PubMed  Google Scholar 

  106. Shulman S, Goldenberg D, Schwartz R, Habot-Wilner Z, Barak A, Ehrlich N, Loewenstein A, Goldstein M (2016) Oral Rifampin treatment for longstanding chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 254:15–22

    Article  CAS  PubMed  Google Scholar 

  107. Siedlecki J, Schworm B, Priglinger SG (2019) The pachychoroid disease spectrum-and the need for a uniform classification system. Ophthalmol Retina 3:1013–1015

    Article  PubMed  Google Scholar 

  108. Siegfried F, Rommel F, Rothe M, Brinkmann MP, Sochurek JAM, Freitag J, Grisanti S, Ranjbar M (2019) Evaluating diurnal changes in choroidal sublayer perfusion using optical coherence tomography angiography. Acta Ophthalmol 97:e1062–e1068

    Article  PubMed  Google Scholar 

  109. Spaide RF, Klancnik JM (2005) Fundus autofluorescence and central serous chorioretinopathy. Ophthalmology 112:825–833

    Article  PubMed  Google Scholar 

  110. Spaide RF, Campeas L, Haas A, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA (1996a) Central serous chorioretinopathy in younger and older adults. Ophthalmology 103:2070–2079 (discussion 2079–2080)

    Article  CAS  PubMed  Google Scholar 

  111. Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA (1996b) Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina 16:203–213

    Article  CAS  PubMed  Google Scholar 

  112. Spaide RF, Gemmy Cheung CM, Matsumoto H, Kishi S, Boon CJF, van Dijk EHC, Mauget-Faysse M, Behar-Cohen F, Hartnett ME, Sivaprasad S, Iida T, Brown DM, Chhablani J, Maloca PM (2021) Venous overload choroidopathy: A hypothetical framework for central serous chorioretinopathy and allied disorders. Prog Retin Eye Res. https://doi.org/10.1016/j.preteyeres.2021.100973

    Article  PubMed  Google Scholar 

  113. Spitznas M (1986) Pathogenesis of central serous retinopathy: a new working hypothesis. Graefes Arch Clin Exp Ophthalmol 224:321–324

    Article  CAS  PubMed  Google Scholar 

  114. Teke MY, Elgin U, Nalcacioglu-Yuksekkaya P, Sen E, Ozdal P, Ozturk F (2014) Comparison of autofluorescence and optical coherence tomography findings in acute and chronic central serous chorioretinopathy. Int J Ophthalmol 7:350–354

    PubMed  PubMed Central  Google Scholar 

  115. Tseng C‑C, Chen S‑N (2015) Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy. Br J Ophthalmol 99(8):1070–1077. https://doi.org/10.1136/bjophthalmol-2014-305353

    Article  PubMed  Google Scholar 

  116. Vasconcelos H, Marques I, Santos AR, Melo P, Pires I, Figueira J, de Abreu JF, Cachulo ML, Silva R (2013) Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 251(7):1697–1705

    Article  CAS  PubMed  Google Scholar 

  117. Venkatesh R, Pereira A, Jayadev C, Prabhu V, Aseem A, Jain K, Bavaharan B, Yadav NK, Chhablani J (2020) Oral eplerenone versus observation in the management of acute central serous chorioretinopathy: a prospective, randomized comparative study. Pharmaceuticals 13:170

    Article  CAS  PubMed Central  Google Scholar 

  118. Verma L, Sinha R, Venkatesh P, Tewari H (2004) Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: a pilot, randomized controlled trial [ISRCTN84128484]. BMC Ophthalmol 4:15

    Article  PubMed  PubMed Central  Google Scholar 

  119. Warrow DJ, Hoang QV, Freund KB (2013) Pachychoroid pigment epitheliopathy. Retina 33:1659–1672

    Article  PubMed  Google Scholar 

  120. Wolfensberger TJ, Chiang RK, Takeuchi A, Marmor MF (2000) Inhibition of membrane-bound carbonic anhydrase enhances subretinal fluid absorption and retinal adhesiveness. Graefes Arch Clin Exp Ophthalmol 238:76–80

    Article  CAS  PubMed  Google Scholar 

  121. Wong R, Chopdar A, Brown M (2004) Five to 15 year follow-up of resolved idiopathic central serous chorioretinopathy. Eye (Lond) 18:262–268

    Article  CAS  Google Scholar 

  122. Wood EH, Karth PA, Sanislo SR, Moshfeghi DM, Palanker DV (2017) Nondamaging retinal laser therapy for treatment of central serous chorioretinopathy: what is the evidence? Retina 37:1021–1033

    Article  PubMed  Google Scholar 

  123. Wu ZHY, Lai RYK, Yip YWY, Chan WM, Lam DSC, Lai TYY (2011) Improvement in multifocal electroretinography after half-dose verteporfin photodynamic therapy for central serous chorioretinopathy: a randomized placebo-controlled trial. Retina 31:1378–1386

    Article  CAS  PubMed  Google Scholar 

  124. Yalcinbayir O, Gelisken O, Akova-Budak B, Ozkaya G, Gorkem Cevik S, Yucel AA (2014) Correlation of spectral domain optical coherence tomography findings and visual acuity in central serous chorioretinopathy. Retina 34:705–712

    Article  PubMed  Google Scholar 

  125. Yannuzzi LA (1986) Type A behavior and central serous chorioretinopathy. Trans Am Ophthalmol Soc 84:799–845

    CAS  PubMed  PubMed Central  Google Scholar 

  126. Yannuzzi LA, Shakin JL, Fisher YL, Altomonte MA (1984) Peripheral retinal detachments and retinal pigment epithelial atrophic tracts secondary to central serous pigment epitheliopathy. Ophthalmology 91:1554–1572

    Article  CAS  PubMed  Google Scholar 

  127. Yannuzzi LA, Slakter JS, Gross NE, Spaide RF, Costa DLL, Huang SJ, Klancnik JM, Aizman A (2003) Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 23:288–298

    Article  PubMed  Google Scholar 

  128. Zhao M, Célérier I, Bousquet E, Jeanny J‑C, Jonet L, Savoldelli M, Offret O, Curan A, Farman N, Jaisser F et al (2012) Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy. J Clin Invest 122:2672–2679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  129. Zhao M, Zhang F, Chen Y, Dai H, Qu J, Dong C, Kang X, Liu Y, Yang L, Li Y et al (2015) A 50 % vs 30 % dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial. JAMA Ophthalmol 133:333

    Article  PubMed  Google Scholar 

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Editorial committee of this supplementary statement

C. Lange (Münster/Freiburg, Germany; lead); B. Bertram (Aachen, Germany); D. Pauleikhoff (Münster, Germany)

Editorial committee of the initial statement in 2018

Clemens Lange, Freiburg, Germany (lead)

F. Treumer, Kassel, Germany

B. Bertram, Aachen, Germany

N. Feltgen, Göttingen, Germany

H. Hoerauf, Göttingen, Germany

D. Pauleikhoff, Münster, Germany

J. Roider, Kiel, Germany

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For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Appendix

Table 1 Table summary of declarations of conflicts of interest. Statement on central serous chorioretinopathy (CSC)

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Professional Association of German Ophthalmologists (Berufsverband der Augenärzte Deutschlands e. V., BVA)., German Society of Ophthalmology (Deutsche Ophthalmologische Gesellschaft, DOG). & German Retina Society e. V. (Retinologische Gesellschaft e. V., RG). Statement of the Professional Association of Ophthalmologists in Germany (BVA), the German Society of Ophthalmology (DOG) and the German Retina Society (RG) on central serous chorioretinopathy. Ophthalmologie 119 (Suppl 2), 108–122 (2022). https://doi.org/10.1007/s00347-022-01614-6

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