Unit 7 - CSCR Flashcards
What are the risk factors of CSCR?
Male
Steroid use
Type A behaviour
Stressful life event
Cushing syndrome
Pregnancy
MEKAR drugs
What are the 3 proposed causes of CSCR?
Choroidal dysfunction:
RPE dysfunction
Pachychoroid disease
How is it proposed that choroidal dysfunction causes CSCR?
Increased hydrostatic pressure in the chorid damages RPE. supported by present of hyper lesions on ICG, increased choroidal thickness and dilated veins in the Haller layer
How is it proposed that pachychoroid disease spectrum causes CSCR?
Diffuse of local thickness in choroidal thickness
Atrophy of inner choroidal layers
Dilated outer choroidal veins
Hyperpermeability on ICG
BUT only associated with hyperopia
What signs are there of CSCR?
smoke stack leakage on FFA
ICG leakage
FAF hypo lesions correspond to leakage areas
What are the two types of CSCR?
Acute and chronic
What are the risk factors for developing chronic CSCR
- Subfoveal choroidal thickness > 500micorn
- PED height > 50micron
- Older than 40
- Photoreceptore atrophy of the detached retina/ granular debris in the SRF on OCT
How long do you need to have a serous RD for atrophic changes to appear on the outer retina?
4-6 months
What is the definition of non-resolving CSCR?
SRF for more thatn 4 months
What treatments can be used in CSCR?
Focal laser
Transpupillary thermotherapy
Subthreshold micropulse laser
PDT
Mineralcorticoid receptor antagonists
Which trial looked at micropulse laser versus PDT in CSR and what were the results?
PLACE trial. PDT was superior
What treatment can be used for CMO
Topical NSAID
Acetazolamide
IV Triamcinolone
Vitrectomy
What does the FFA look like on CMO?
Leakage around disc
Late leakage in petalloid appearance around fovea
What is the Diff Dx in CMO?
DR
RVO
Wet AMD
Radiation retinopathy
