Comparing interventions for chronic central serous chorioretinopathy: A network meta-analysis

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Treatments

Background:

• Chronic central serous chorioretinopathy (CSCR) is a condition affecting vision, persisting longer than 3 months.
• Effective treatment options for chronic CSCR require further investigation.

Purpose of the Study:

• To compare the efficacy of four treatment classes for chronic CSCR: photodynamic therapy (PDT), subthreshold laser therapies (SLT), mineralocorticoid receptor antagonists (MRA), and anti-VEGF agents.
• To evaluate outcomes including subretinal fluid (SRF) resolution, visual acuity, and retinal thickness.

Main Methods:

• A network meta-analysis (NMA) was conducted on data from eleven randomized controlled trials (RCTs) involving 458 eyes.
• Primary outcomes included SRF resolution, best corrected visual acuity (BCVA), and SRF changes at 3, 6, and 12 months.
• Certainty of evidence was assessed using Confidence in Network Meta-Analysis (CINeMA).

Main Results:

• At 3 months, both PDT and SLT demonstrated superiority over control in resolving SRF.
• SLT also showed superiority over control in improving BCVA.
• PDT was found to be superior to SLT in improving central retinal thickness (CRT).

Conclusions:

• PDT and SLT appear to be the most promising treatments for chronic CSCR at 3 months based on current evidence.
• The low confidence in the evidence and the limited number of studies prevent definitive conclusions.
• Further high-quality research is needed to establish the long-term efficacy and safety of these treatments.