Preferred practice pattern in central serous chorioretinopathy

Br J Ophthalmol. 2017 May;101(5):587-590. doi: 10.1136/bjophthalmol-2016-309247. Epub 2016 Aug 18.

Abstract

Purpose: Central serous chorioretinopathy (CSC) management lacks well-defined guidelines given the variable natural history of this disease and the lack of prospective trials. We conducted an online preferred physician practice survey to track international trends and variations in the management of CSC data.

Methods: We designed and distributed an online 27-item questionnaire with secure confidential access to retina specialists with a publication record in CSC. Physicians with at least one publication as first or corresponding author in any national or international peer reviewed journal in the English language on CSC within the last 2 years on PubMed were included. Participants were masked to the responses from other participants.

Results: The response rate was 82.3% (107 out of 130). 79.1% physicians preferred to observe cases of acute CSC. For chronic cases, 66.7% offered photodynamic therapy (PDT) as first line treatment. The most commonly used PDT protocol was full dose and half-fluence (60.6%). For chronic cases with intraretinal cystic changes, 43.1% opted for observation. Enhanced depth imaging, optical tomography was a common diagnostic tool for 59.8%, while indocyanine green angiography was only used by 37.8%. One regional difference was a preference for focal laser in Asia for initial treatment.

Conclusions: While there are some common practice patterns for of CSC, there are still variations in regional and individual practice patterns indicating the need to establish more definitive practice guidelines. This survey data could be useful to plan a prospective study to address many unanswered questions.

Keywords: Retina.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Central Serous Chorioretinopathy* / diagnosis
  • Central Serous Chorioretinopathy* / therapy
  • Fluorescein Angiography / methods
  • Humans
  • Indocyanine Green
  • Laser Coagulation / methods
  • Optical Imaging / methods*
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins / therapeutic use
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies
  • Tomography, Optical Coherence

Substances

  • Angiogenesis Inhibitors
  • Photosensitizing Agents
  • Porphyrins
  • Indocyanine Green