[Pathogenesis and therapy of central serous retinopathy]

There is no consensus in the literature on the etiology and therapy of central serous retinopathy. We conducted a retrospective study to find out whether patients treated with argon laser coagulation (ALK) experienced long-term visual acuity improvement. We were also concerned to find whether choroidal perfusion was involved in the etiology.

In all, 28 patients (4 women/24 men) with RCS confirmed by angiography were analyzed. All patients were followed up from 1988 to 1992. Patients with chronic recurrent RCS were not considered. Angiography was performed to examine the type and localization of the leakage and also the choroidal perfusion. Patients who were treated with ALK were compared with patients who were not.

Only 9 patients were treated with carefully directed ALK. Their mean visual acuity was 0.5 (STD 0.09) before therapy. After treatment the mean visual acuity was improved to an average of 0.8 (0.23). The follow-up time was up to 56 weeks. The patients without ALK had an initial visual acuity of 0.6 (0.21) which improved to 0.8 (0.22) during an observation period of 60 weeks. By the end of the study the visual acuity was the same in both groups. In 46% of all patients delayed choroidal perfusion was seen on angiography.

There was no difference in visual acuity between patients treated with and without ALK. The angiographic examinations suggest general changes in choroidal perfusion in patients with RCS.