More detailed observations and a further understanding of the condition, mainly through better-characterized FA findings, finally led to the term ‘idiopathic central serous choroidopathy' by Gass, which over time has been adjusted to ‘central serous chorioretinopathy' owing to the knowledge about the hyperpermeability of the RPE. In 1965 Maumenee was the first to publish his observation on leakage, which he made during FA at the level of the retinal pigment epithelium (RPE), suggesting involvement of both the RPE and the choroid. The concept of a vasospastic disease did not change until fluorescein angiography (FA) was introduced in ophthalmology, allowing a better understanding of the disease. Later concepts included Gifford and Marquardt's ‘central angiospastic retinopathy' in 1939 as they believed an angiopathy with an abnormal vessel muscle tone was the reason for this disorder. Rather, he believed that it was a constitutional angioneurosis which caused vasospasm and subsequent exudation in these patients.
Horniker was the first to revise von Graefe's idea of an inflammation as the underlying reason for the disease, as he observed patients with this condition without any previous history of syphilis. The evolution of the term ‘central serous chorioretinopathy' has always been closely linked to the conception of the pathomechanism underlying this disease at the respective point in time. We illuminate modern diagnostic tools as well as current treatment options in the context of CSC, particularly in the light of a better understanding of corticosteroids and their receptors involved in its pathogenesis.Ĭolor fundus photography of the left eye of a 35-year-old female patient with impressive PED in the macular region and RPE depigmentation (arrow). In this review article, we give an overview of its epidemiology, the current understanding of its pathogenesis as well as systemic and ocular risk factors. Even though most cases of CSC are self-limiting, severe as well as recurrent courses exist, and for these patients only a limited number of treatment options are available: laser photocoagulation, with a risk of scotoma and choroidal neovascularization, and photodynamic therapy. The involvement of corticosteroids is undisputed, although their exact role has not been clarified other parts of the underlying mechanism of CSC have been mainly elucidated by imaging techniques such as fluorescein and indocyanine green angiography. The pathogenesis of central serous chorioretinopathy (CSC) is still not fully understood.
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