Central serous chorioretinopathy risk factors in the mid-Euphrates region, Iraq

Central serous chorioretinopathy (CSC) is an ophthalmic disorder that often affects young male patients under psychological stres and is clinically characterized by blurring of vision, metamorphopsia, a visual abnormality in which normally straight lines appears curved, and micropsia, a visual abnormality in which objects appear smaller than normal. The annual incidence of the condition is not well recognized in our country. The objective of this cross-sectional study was to highlight the incidence rate of CSC in our community and to make an insight on possible associated risk factors. This cross-sectional study included 92 patients with vissual impairment that has been proved due to central serous chorioretinoplathy (CRC). The sample included 68 males and 24 females. The sample of CRC was all the available patients visiting ophthalmology unit at Al-Diwaniyah teaching hospital and at the ophthalmology unit at Medical Committee Instituion, both these health centers lie at Al-Diwaniyah province, mid-Euphrates region, Iraq. A rough estimation of the annual incidence of CRC in this mid-Euphrates region of Iraq was 3.5 per 100.000. Mean age of patients was 43.02 ± 4.71 years, and the disease was 2.83 times more common in males. The main possible risk factors are psychosocial stress and steroid therapy. CRC is common in our community, and the main possible risk factors are psychosocial stress, and steroid use and these associations need to be validated in a large longitudinal study or at least a case-control study

Structural and Functional Outcomes in Chronic Central Serous Chorioretinopathy Treated with Photodynamic Therapy

PURPOSE: To study the retinal pigment epithelium (RPE) and retinal alterations in chronic central serous chorioretinopathy treated with photodynamic therapy, and its correlation with functional parameters such as best-corrected visual acuity (BCVA) and contrast sensitivity (CS). METHODS: Retrospective, noncomparative, consecutive evaluation by optical coherence tomography and its correlation with BCVA and CS in 31 eyes of 26 patients. RESULTS: In all affected patients, 88.5% were male with a mean age of 42.9 years. The right eye was involved in 64.5% of cases, bilateral in 19% and 73.9% were hyperopic (spherical refraction between 0 and +5.0 diopters). Of these cases, 51.5% had peri-RPE abnormalities, 17.3% hyperreflective substances at RPE, 19.4% RPE atrophy, 55.3% foveolar atrophy, 3.1% pigment epithelial detachment, 5.2% subretinal fluid persistence, 8.3% fibrin deposits, 68.4% photoreceptor inner and outer segment line interruption and 31.1% external limiting membrane interruption. CONCLUSIONS: Time evolution and number of outbreaks were related to the decrease in foveal and chorodial thickness and in those with worse BCVA and CS. RPE abnormalities and atrophy were related to the age of onset of symptoms. Photoreceptor elongation has been correlated with poor BCVA and inner and outer segment line destructuring and interruption with poor CS.

Advances in the treatment of central serous chorioretinopathy

Central serous chorioretinopathy is a disease that is partly understood. Novel advancements have led to further understanding of the disease, and have identified choroidal dysfunction as the principal element in CSCR development. New imaging tools have aided in better monitoring disease response to various treatment models. Enhanced depth imaging optical coherence tomography, in particular, has helped in observing choroidal thickness changes after various treatment models. To date, photodynamic therapy and focal laser remain the main stay of treatment. More understanding of disease pathophysiology in the future will help in determining the drug of choice and the best management option for such cases

A Case of Idiopathic Central Serous Chorioretinopathy in a 12-year-old Male Treated with Bevacizumab

A 12-year-old male presented with a chief complaint of a 1-month-history of decreased visual acuity in his right eye. The patient had no past history of steroid use or other systemic diseases. On fundus examination, which included fluorescent angiography (FAG) and optical coherence tomography (OCT), the patient was diagnosed with idiopathic central chorioretinopathy, whose clinical course was monitored without any specific treatments. At the time of admission, the best-corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye. On fundoscopy, a serous detachment of 1 disc diameter in size was observed in the posterior pole. According to the FAG and the OCT, serous neurosensory detachment was present. After two months of monitoring the clinical course, the best corrected visual acuity in the right eye was 0.8, and there was improvement of neurosensory retinal detachment. However, OCT detected recurrence after five months, and the corrected visual acuity was decreased to 0.6. Bevacizumab was then injected into the vitreous cavity. Complete resolution of the subretinal fluid resulted eight months later, and the corrected visual acuity improved to 1.0.

Outcome of laser photocoagulation in chronic and recurrent central serous chorioretinopathy

To evaluate the outcome of laser photocoagulation in recurrent and chronic non resolving Central Serous Chorioretinopathy [CSCR]. In this interventional case series 9 eyes of 9 patients with recurrent or chronic CSCR underwent focal laser photocoagulation. Best corrected visual acuity [BCVA], Fluorescein Angiography [FA], Optical Coherence Tomography [OCT] were performed prior to treatment as baseline workup while BCVA and OCT were reassessed at 1 week, 1 month and three months after treatment. One month after treatment, CSCR in 5 [55.55%] eyes was completely resolved, 3 [33.33%] eyes showed partial resolution of sub-retinal fluid [SRF] while in 1 [11.11%] eye SRF did not resolve at all. However after 3 months residual SRF in 2 [22.22%] eyes resolved completely while the status of other 2 [22.22%] eyes remained same. The treatment of chronic or recurrent CSCR with laser photocoagulation may result in prompt resolution of sub-retinal fluid which can be associated with rapidly improved vision. Although this case series is limited in follow up and number of patients, the encouraging results and lack of visually significant complications suggests need for further evaluation