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Purpose <p>Central serous chorioretinopathy (CSCR) is characterized by serous neurosensory retinal detachment that predominantly affects working-age men. Many acute cases resolve spontaneously, but chronic or recurrent forms can lead to permanent visual impairment. Oral pharmacological therapies have emerged as a noninvasive alternative to photodynamic therapy (PDT), particularly in the context of verteporfin shortage. This systematic review aims to evaluate the efficacy of oral agents for CSCR, focusing on subretinal fluid (SRF), best-corrected visual acuity (BCVA), choroidal thickness, and recurrence.</p> Methods <p>Following PRISMA 2020 guidelines, we searched MEDLINE, the Cochrane Library, and Web of Science (January 1990 to May 2025) for randomized controlled trials (RCTs) assessing oral therapies for CSCR. Risk of bias was assessed using the Cochrane RoB 2.</p> Results <p>Our search returned 14 trials that met our inclusion criteria. We found that mineralocorticoid receptor antagonists appeared to reduce SRF in most studies (6 of 8 trials), while their effects on BCVA and choroidal thickness were inconsistent. <i>Helicobacter pylori</i> eradication therapy showed no significant SRF reduction or effects on BCVA compared to placebos or control group. Propranolol improved both complete SRF resolution and BCVA, while metipranolol demonstrated no significant effects. Due to high heterogeneity between studies, we did not perform a meta-analysis.</p> Conclusion <p>Mineralocorticoid receptor antagonists may reduce SRF in CSCR, although visual outcomes remain uncertain. Propranolol may offer potential benefit based on limited evidence. Other oral therapies lack supportive evidence. Given study heterogeneity and absence of meta-analysis, findings should be interpreted with caution. Further large-scale RCTs are needed.</p>

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Oral therapeutic interventions for central serous chorioretinopathy: A systematic review

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Ferdiriva Hamzah,
  • Amalia Azrina,
  • Supanji Supanji,
  • Gitalisa Andayani Adriono,
  • Ari Shinojima

摘要

Purpose

Central serous chorioretinopathy (CSCR) is characterized by serous neurosensory retinal detachment that predominantly affects working-age men. Many acute cases resolve spontaneously, but chronic or recurrent forms can lead to permanent visual impairment. Oral pharmacological therapies have emerged as a noninvasive alternative to photodynamic therapy (PDT), particularly in the context of verteporfin shortage. This systematic review aims to evaluate the efficacy of oral agents for CSCR, focusing on subretinal fluid (SRF), best-corrected visual acuity (BCVA), choroidal thickness, and recurrence.

Methods

Following PRISMA 2020 guidelines, we searched MEDLINE, the Cochrane Library, and Web of Science (January 1990 to May 2025) for randomized controlled trials (RCTs) assessing oral therapies for CSCR. Risk of bias was assessed using the Cochrane RoB 2.

Results

Our search returned 14 trials that met our inclusion criteria. We found that mineralocorticoid receptor antagonists appeared to reduce SRF in most studies (6 of 8 trials), while their effects on BCVA and choroidal thickness were inconsistent. Helicobacter pylori eradication therapy showed no significant SRF reduction or effects on BCVA compared to placebos or control group. Propranolol improved both complete SRF resolution and BCVA, while metipranolol demonstrated no significant effects. Due to high heterogeneity between studies, we did not perform a meta-analysis.

Conclusion

Mineralocorticoid receptor antagonists may reduce SRF in CSCR, although visual outcomes remain uncertain. Propranolol may offer potential benefit based on limited evidence. Other oral therapies lack supportive evidence. Given study heterogeneity and absence of meta-analysis, findings should be interpreted with caution. Further large-scale RCTs are needed.