Central serous chorioretinopathy
ICD-10 H35.7 · ICD-11 9B75.2

Treatment of Central Serous Chorioretinopathy with Non-Resolving Subretinal Fluid and Focal Extrafoveal Leakage

This protocol addresses patients with central serous chorioretinopathy (CSC) in whom subretinal fluid has not resolved — or has recurred — and who have discrete leakage site(s) on fundus fluorescein angiography (FFA) located more than 500 μm from the fovea.

Clinical Scenario

Non-resolving or recurrent CSC with focal extrafoveal leakage site(s) on FFA. The leakage points are situated beyond 500 μm from the fovea, making the presentation suitable for a targeted intervention limited to those identified sites.

Treatment Approach (partial overview)

Management in this setting involves a focal, image-guided laser-based intervention applied directly to the discrete leakage sites identified on FFA. The complete regimen — including site selection criteria, procedural parameters, and the full decision algorithm — is contained in the structured protocol.

Treatment Goal

Resolution of neurosensory retinal detachment

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/ceo.14201

The use of focal photocoagulation tends to be reserved for non-resolving or recurrent CSC, when there are no more than a few extrafoveal leakage sites.

Due to the destructive nature of its mechanism, its application is typically limited to leakage sites >500 μm from the fovea.

Focal laser photocoagulation in CSC typically involves application of argon laser to distinct sites of leakage identified on FFA.

Studies have found that laser photocoagulation may reduce the duration of CSC episodes compared to observation or sham laser by up to 2 months, with faster resolution of neurosensory retinal detachment and increased speed of visual acuity improvement.

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