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Systemic complement activation in central serous chorioretinopathy
Elon H C van Dijk1, Roula Tsonaka2, Ngaisah Klar-Mohamad3
1Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
Insights
This study found no evidence of systemic complement system activation or inhibition in patients with chronic central serous chorioretinopathy (CSC). Complement pathways and activation products did not differ between CSC patients and controls.
Area of Science:
- Ophthalmology
- Immunology
- Genetics
Background:
- Genetic variants in the complement system are linked to chronic central serous chorioretinopathy (CSC).
- Age-related macular degeneration, which shares features with CSC, involves genetic risk factors and complement system activation.
- The role of systemic complement activation in chronic CSC remains unclear.
Purpose of the Study:
- To investigate systemic complement system activation or inhibition in patients with chronic CSC.
- To determine if complement pathways or activation products differ between chronic CSC patients and healthy controls.
Main Methods:
- A prospective case-control study involving 76 chronic CSC patients and 29 controls.
- Analysis of complement activity (classical, alternative, mannose-binding lectin pathways) in serum or plasma.
- Measurement of complement factors, activation products (C3d, C5a, sC5b-C9), and C3d/C3 ratio, with adjustments for confounding factors.
Main Results:
- No significant differences were found in tested complement variables between CSC patients and controls.
- No associations were observed between complement system markers and CSC disease activity.
- No correlation was found between complement markers and steroid use in CSC patients.
Conclusions:
- This study did not find evidence supporting a link between chronic CSC and systemic complement activation or inhibition.
- The findings contrast with existing literature suggesting a relationship between complement gene variants and CSC.
- Further research may be needed to fully elucidate the role of the complement system in CSC pathogenesis.
Purpose:
A clear link between several variants in genes involved in the complement system and chronic central serous chorioretinopathy (CSC) has been described. In age-related macular degeneration, a disease that shows clinical features that overlap with CSC, both genetic risk factors and systemic activation of the complement system have previously been found. In this case-control study, we assessed whether there is evidence of either systemic activation or inhibition of the complement system in patients with chronic CSC.
Methods:
A prospective case-control study of 76 typical chronic CSC patients and 29 controls without ophthalmological history was conducted. Complement activity assays (classical, alternative, and mannose-binding lectin pathway), complement factors 3, 4, 4A, 4B, B, D, H, I, and P, activation products C3d, C5a, and sC5b-C9, and the C3d/C3 ratio were analysed in either serum or plasma. A correction for possible effects of gender, age, body mass index, and smoking status was performed.
Results:
In this study, none of the tested variables, including regulation and activation products, proved to be significantly different between the groups. Moreover, no associations with either CSC disease activity or possible CSC related steroid use were observed.
Conclusion:
Despite the available literature regarding a possible relationship between chronic CSC and variants in genes involved in the complement system, we did not find evidence of an association of chronic CSC with either systemic complement activation or inhibition.
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