Present views of the pathogenesis and treatment of central serous chorioretinopathy

The central serous chorioretinopathy is a disease which has been known since 1866. Even the papers published in recent time did not report anything unequivocal concerning its etiology which remains obscure. A year ago, Spitznas submitted a new interesting working hypothesis to explain the pathogenesis of this disease. At present, in the treatment of CSCH, the method of choice is the direct laser photocoagulation. The best results are so far obtained with the treatment using the red crypton laser beam. This is due to its biological effects on the tissues of the eye. The effects of the selected green beam of the argon laser are similar to those of the red crypton light. In accordance with our experiences, its application is useful for direct photocoagulation of CSCH. It does not lead to the development of a positive central scotoma and that not even in close proximity of the foveola up to the distance of 200 microns from the avascular zone. This is given by its biological effects and the small extent of the coagulated area of the retina. When the leakage is nearer than 200 microns from the margin of the avascular zone of the foveola, it is suitable to treat CSCH conservatively. The risk of a permanent iatrogenic damage of the central visual acuity or the development of subretinal neovascular membranes is minimal on direct photocoagulation of CSCH with green light of the argon laser under simultaneous fluoroscopy, and utilization of suitable parameters of the treatment. The clinician must, however, take this risk into consideration when contemplating the advantage which is gained, namely the shortening of the duration of the disease.