HNY Central Digital Repository - Hull

Chronic Central Serous Retinopathy (CSR) 

This intervention is commissioned if the patient:  

• meets the definition for Chronic CSR, having not resolved within 6 months AND 
• has worsening visual acuity (evidenced with serial visual acuity readings)  

This policy does not apply to ‘Acute CSR’ or ‘Acute Persistent CSR’. 

Use should be prioritised in line with published guidance from the Royal College of Ophthalmologists. 

The majority of cases of CSR (Acute CSR or Acute Persistent CSR) resolve spontaneously, often within three months of diagnosis, but for a small cohort of patients the condition persists, resulting in Chronic CSR. 

Evidence regarding the optimal treatment of chronic central serous chorioretinopathy (CSCR) is so far inconclusive. Good visual and anatomic results in chronic CSR have been demonstrated with Verteporfin photodynamic therapy (PDT). Photodynamic therapy (PDT) and subthreshold laser were the best treatments on probability ranking in a recent network meta-analysis. 

Due to an ongoing global supply shortage of Verteporfin (Visudyne), the Royal College of Ophthalmologists has published guidance on clinical prioritisation. 

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.pdf (rcophth.ac.uk)