Multimodal Treatment Outcomes in Chronic Central Serous Chorioretinopathy: A Case Study
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Multimodal Treatment Outcomes in Chronic Central Serous Chorioretinopathy: A Case Study
Authors:
Namrata Srivastava1, Sanjana Gupta2
1Department of Optometry ERA University of Allied Health Science, Lucknow, Uttar Pradesh, India.2Department of Optometry T.S.Mishra Lucknow, Uttar Pradesh, India.
Abstract
Purpose:
This case study evaluates the clinical progression and visual outcomes in a patient with a severe form of chronic central serous chorioretinopathy (cCSC), aiming to assess the efficacy of multimodal treatments—particularly photodynamic therapy (PDT)—in managing recurrent central serous retinopathy (CSR). Insights are contextualized with recent literature from 2020–2025, including Breukink et al. (2020).
Methods:
A 45-year-old male with recurrent CSR was followed from 2018 to 2025 at Dr. Jawahar Lal Rohtagi Hospital, Semi-Government Allied Health & Paramedical Institute, Kanpur.. Clinical evaluation included OCT, FA, FAF, and BCVA assessments. Subretinal fluid was confirmed, with a baseline BCVA of 20/40. Management involved half-dose PDT, navigated laser photocoagulation, anti-VEGF therapy for CNV, oral eplerenone, and lifestyle modifications. Risk factors such as stress, corticosteroid use, and past smoking were addressed. Quality-of-life was monitored using the NEI-VFQ-39 questionnaire, ensuring a comprehensive and multidisciplinary approach to long-term disease management.
Results:
CSR relapses occurred in 2020, 2021, and 2023, progressing to cCSC with CNV. Although SRF resolved after each intervention, final BCVA declined to 20/50 due to photoreceptor loss and diffuse retinal pigment epithelium (RPE) atrophy. A NEI-VFQ-39 score of 65/100 indicated moderate visual function impairment. These findings align with Breukink et al., underscoring that anatomical resolution does not ensure visual recovery.
Conclusion:
Despite treatment success in SRF resolution, irreversible retinal damage may limit visual recovery in cCSC. Early, personalized, and continuous intervention is essential.
Keywords:
Central Serous Retinopathy, Chronic CSC, Photodynamic Therapy, Anti-VEGF, Multimodal Imaging, RPE Atrophy, Subretinal Fluid, Visual Outcomes.
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