HNY Policy and Pathway Repository - North Lincolnshire

Chronic Central serous retinopathy (CSR)

This intervention is commissioned (*) if the patient:

• meets the definition for Chronic CSR, having not resolved within 4 months AND 
• has worsening visual acuity (evidenced with serial visual acuity readings) AND
• does not have permanent macular damage

 

This intervention is not commissioned for ‘Acute CSR’ or ‘Acute Persistent CSR’. 

 

*Use should be prioritised in line with published guidance from the Royal College of Ophthalmologists (RCOpth). The RCOpth has recommended Verteporfin be reserved for ocular oncology indications and made recommendations for prioritisation for non-ocular oncology conditions, but it is expected until supply improves, that there will be insufficient supply in the UK to allow treatment of patients with Chronic CSR.

In many cases CSR resolves spontaneously within 3-6 months. In a small number of patients the symptoms persist, resulting in chronic CSR.

 

Good visual and anatomic results in chronic CSR have been demonstrated with Verteporfin PDT. PDT and subthreshold laser were the best treatments on probability ranking in a recent network meta-analysis. Half-dose of Verteporfin PDT is currently considered the most effective treatment option for Chronic CSR by the RCOpth.

 

There has been a worldwide shortage of Verteporfin since 2021, and supply is not expected to improve until 2026.

Scenario: Confirmed AMD | Management | Macular degeneration - age-related | CKS | NICE

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

Clinical Prioritisation Guidance for Limited Stock of Verteporfin (Visudyne) for Photodynamic Therapy (PDT) for Central Serous Chorioretinopathy (CSR) April 2025 (RCOpth)