Do We Need to Act Fast in Central Serous Chorioretinopathy? - A Comparative Study

Abstract

Background: Central serous chorioretinopathy (CSCR) is a sporadic disorder of the outer blood-retinal barrier, characterized by a localized detachment of the sensory retina usually affecting one eye in young males. Usually, a self-limiting disease various treatments have been investigated in recent times. Aim: To evaluate the final visual outcome, recurrence rate, and possible complications in patients of CSCR treated with observation, oral acetazolamide, oral eplerenone, and double-frequency neodynium-doped yttrium aluminium garnet (ND-YAG) laser photocoagulation. Methods: A prospective interventional study was conducted on patients newly diagnosed with CSCR. The patients were divided into four groups namely: Group A on observation, Group B on oral acetazolamide Group C on oral eplerenone, and Group D on Double frequency Nd-YAG laser. The visual recovery, recurrence rate, and possible complications of these therapies were compared. Results: The study comprised of 76 patients. Group D patients showed the fastest improvement in visual acuity at 2 weeks. At 12 weeks, all groups had comparable improvement. Three patients in Group A, 1 each in Groups B and D, and 2 in Group C showed recurrence. Paresthesia, numbness, and gastric upset related to acetazolamide were noted in 5 patients of Group B. However, 16.7% of cases in Group A, 10.5% in Group B, 5.3% in Group C, and 5% in Group D showed leakage on Fundus fluorescent angiography after 12 weeks. Conclusion: In acute CSCR eplerenone seems to be efficient with the least side effects and early resolution. In chronic cases, Double frequency Nd-YAG laser seems to give better results. Early treatment should be given for better visual recovery of patients.

Keywords

• acetazolamide
• central serous chorioretinopathy
• double frequency nd-yag laser
• eplerenone