Scolaris Content Display Scolaris Content Display

Intervenciones para la coriorretinopatía serosa central: un metanálisis en red

Collapse all Expand all

References

Referencias de los estudios incluidos en esta revisión

Jump to:

Bae 2011 {published data only}

Bae SH, Heo J, Kim C, Kim TW, Shin JY, Lee JY, et al. Low‐fluence photodynamic therapy versus ranibizumab for chronic central serous chorioretinopathy: one‐year results of a randomized trial. Ophthalmology 2014;121(2):558‐65.
Bae SH, Heo JW, Kim C, Kim TW, Lee JY, Song SJ, et al. A randomized pilot study of low‐fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy. American Journal of Ophthalmology 2011;152(5):784‐92.

Boscia 2008 {published data only}

Boscia F, Michele R, Antonio L, Nicola C, Claudio F, Salvatore F, et al. Low fluence photodynamic therapy in chronic central serous chorioretinopathy: blind randomized clinical trial of efficacy and safety. The Macula Society2008:118.
Boscia F, Reibaldi M, Longo A, Faro S, Uva M, Cardascia N, et al. Low fluence photodynamic therapy in chronic central serous chorioretinopathy: blind randomised clinical trial of efficacy and safety. Investigative Ophthalmology and Visual Science2008:ARVO E‐abstract 3278.

Brancato 1994 {published data only}

Brancato R, Bandello F. Treatment of central serous chorioretinopathy with beta‐blockers and calcium antagonists. The Macula Society1994:114.

Browning 1993 {published data only}

Browning DJ. Nadolol in the treatment of central serous retinopathy. American Journal of Ophthalmology1993; Vol. 116, issue 6:770‐1.

Chan 2006 {published data only}

Chan PS, Uy HS, Salvosa F, Silva PA. Low dose transpupillary thermotherapy for the treatment of central serous chorioretinopathy. American Academy of Ophthalmology2006:290.

Chan 2008 {published data only}

Chan WM, Lai TY, Lai RY, Liu DT, Lam DS. Half‐dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one‐year results of a randomized controlled trial. Ophthalmology 2008;115(10):1756‐65.
Wu ZH, Lai RY, Yip YW, Chan WM, Lam DS, Lai TY. Improvement in multifocal electroretinography after half‐dose verteporfin photodynamic therapy for central serous chorioretinopathy: a randomized placebo‐controlled trial. Retina 2011;31(7):1378‐86.

Coskun 2014 {published data only}

Coskun E, Gurler B, Erbagci I. Combined half dose photodynamic therapy with verteporfin and intravitreal bevacizumab for chronic central serous chorioretinopathy. Ophthalmologica 2014;232:56.

Dang 2013 {published data only}

Dang Y, Mu Y, Zhao M, Li L, Guo Y, Zhu Y. The effect of eradicating Helicobacter pylori on idiopathic central serous chorioretinopathy patients. Therapeutics and Clinical Risk Management2013; Vol. 9, issue 1:355‐60.

Kianersi 2008 {published data only}

Kianersi F, Fesharaki F. Effects of propranolol in patients with central serous chorioretinopathy. Journal of Research in Medical Sciences 2008;13(3):103‐7.

Kim 2013 {published data only}

Kim M, Lee SC, Lee SJ. Intravitreal ranibizumab for acute central serous chorioretinopathy. Ophthalmologica 2013;229(3):152‐7.

Klatt 2011 {published data only}

Klatt C, Saeger M, Oppermann T, Pörksen, E, Treumer F, Hillenkamp J, et al. Selective retina therapy for acute central serous chorioretinopathy. British Journal of Ophthalmology2011; Vol. 95, issue 1:83‐8.

Leaver 1979 {published data only}

Ficker L, Vafidis G, While A, Leaver P. Long term results of treatment of central serous retinopathy ‐ a preliminary report. Transactions of the Ophthalmological Societies of the United Kingdom 1986;105(Pt 4):473‐5.
Ficker L, Vafidis G, While A, Leaver P. Long‐term follow‐up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy. British Journal of Ophthalmology 1988;72(11):829‐34.
Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy. British Journal of Ophthalmology1979; Vol. 63, issue 10:674‐7.

Lim 2010 {published data only}

Lim JW, Ryu SJ, Shin MC. The effect of intravitreal bevacizumab in patients with acute central serous chorioretinopathy. Korean Journal of Ophthalmology 2010;24(3):155‐8.

Ontiveros‐Orozco 2004 {published data only}

Ontiveros‐Orozco I, Garcia‐Franco R, Levine‐Berebichez A, Celis‐Suazo B, Rojas‐Juarez S. Topical brinzolamide for the treatment of idiopathic central serous chorioretinopathy. Investigative Ophthalmology and Visual Science2004; Vol. 45:ARVO E‐abstract 529.
Ontiveros‐Orozco I, García‐Franco R, Levine‐Berevichez A, López‐Star EM, Rojas‐Juárez S, Celis‐Suazo B, et al. Brinzolamide for topical treatment coroidorretinopatía idiopathic central serous [Brinzolamida tópica para el tratamiento de lacoroidorretinopatía serosa central idiopática]. Revista Mexicana de Oftalmología 2006;80(3):132‐7.

Pitcher 2015 {published data only}

Pitcher JD, Witkin AJ, DeCroos FC, Ho AC. A prospective pilot study of intravitreal aflibercept for the treatment of chronic central serous chorioretinopathy: the CONTAIN study. British Journal of Ophthalmology 2015;99(6):848‐52.

Rahbani‐Nobar 2011 {published data only}

Rahbani‐Nobar MB, Javadzadeh A, Ghojazadeh L, Rafeey M, Ghorbanihaghjo A. The effect of Helicobacter pylori treatment on remission of idiopathic central serous chorioretinopathy. Molecular Vision 2011;17:99‐103.

Ratanasukon 2012 {published data only}

Ratanasukon M, Bhurayanontachai P, Jirarattanasopa P. High‐dose antioxidants for central serous chorioretinopathy; the randomized placebo‐controlled study. BMC Ophthalmology 2012;12:20.

Robertson 1983 {published data only}

Robertson DM, Ilstrup D. Direct, indirect, and sham laser photocoagulation in the management of central serous chorioretinopathy. American Journal of Ophthalmology 1983;95(4):457‐66.

Roisman 2013 {published data only}

Roisman L, Magalhaes FP, Lavinsky D, Moraes N, Hirai FE, Cardillo JA, et al. Micropulse diode laser treatment for chronic central serous chorioretinopathy: a randomized pilot trial. Ophthalmic Surgery Lasers and Imaging 2013;44(5):465‐70.

Sawa 2014 {published data only}

Sawa M, Gomi F, Hara C, Nishida K. Effects of a lutein supplement on the plasma lutein concentration and macular pigment in patients with central serous chorioretinopathy. Investigative Ophthalmology and Visual Science2014; Vol. 55, issue 8:5238‐44.

Semeraro 2012 {published data only}

Semeraro F, Romano MR, Danzi P, Morescalchi F, Costagliola C. Intravitreal bevacizumab versus low‐fluence photodynamic therapy for treatment of chronic central serous chorioretinopathy. Japanese Journal of Ophthalmology 2012;56(6):608‐12.

Shang 1999 {published data only}

Shang Q, Liu C, Wei S, Shi F, Yang A. Wavelength selection in management of central serous chorioretinopathy. Chinese Journal of Ophthalmology 1999;35(6):413‐5.

Verma 2004 {published data only}

Verma L, Sinha R, Venkatesh P, Tewari HK. Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: a pilot, randomized controlled trial. ISRCTN84128484. BMC Ophthalmology 2004;4(1):15.

Zhang 2012 {published data only}

Zhang YL, You ZP, Wang CY. Different doses of verteporfin photodynamic therapy for central exudative chorioretinopathy. Chinese Journal of Experimental Ophthalmology 2012;30(11):1030‐5.

Zhao 2015 {published data only}

Zhao M, Zhang F, Chen Y, Dai H, Qu J, Dong C, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one‐year results of a randomized clinical trial. JAMA Ophthalmology 2015;133(3):333‐40.

Referencias de los estudios excluidos de esta revisión

Jump to:

Ainiwaer 2014 {published data only}

Ainiwaer K, Xiong LJ. Efficacy of compound Xueshuantong combined laser therapy on central serous chorioretinopathy. International Eye Science 2014;14(10):1841‐3.

Arevalo 2013 {published data only}

Arevalo JF, Espinoza JV. Combined photodynamic therapy with verteporfin and intravitreal anti‐vascular endothelial growth factor therapy for chronic central serous chorioretinopathy. Graefes Archive for Clinical and Experimental Ophthalmology 2013;251(1):403‐4.

Aydin 2013 {published data only}

Aydin E. The efficacy of intravitreal bevacizumab for acute central serous chorioretinopathy. Journal of Ocular Pharmacology and Therapeutics 2013;29(1):10‐3.

Beger 2012 {published data only}

Beger I, Koss M J, Koch F. Treatment of central serous chorioretinopathy: micropulse photocoagulation versus bevacizumab. Der Ophthalmologe 2012;109(12):1224‐32.

Behnia 2013 {published data only}

Behnia M, Khabazkhoob M, Aliakbari S, Abadi A E, Hashemi H, Pourvahidi P. Improvement in visual acuity and contrast sensitivity in patients with central serous chorioretinopathy after macular subthreshold laser therapy. Retina 2013;33(2):324‐8.

Bi 2000 {published data only}

Bi HS, Liu L, Wang XR, Yang MY. Treatment of central serous chorioretinopathy with krypton yellow and green laser photocoagulation. Ophthalmology 2000;9(3):166‐8.

Boscia 2007 {published data only}

Boscia F, Caradscia N, Furino C, Dammacco R, Sborgia G, Reibaldi M. Photodynamic therapy with low fluence PDT for chronic central serous chorioretinopathy: a short term pilot study. Investigative Ophthalmology and Visual Science2007; Vol. 48:ARVO E‐Abstract 4151.

Bruha 1972 {published data only}

Bruha H. Therapy of the so‐called chorioretinitis centralis serosa with the laser‐coagulator. Klinische Monatsblatter fur Augenheilkunde 1972;160(3):340‐6.

Cervera 2008 {published data only}

Cervera E, Montero J, Torralba C, Palomares P, Hernandez M. Low dose photodynamic therapy for chronic central serous chorioretinopathy. Archivos de la Sociedad Espanola de Oftalmologia 2008;83(9):525‐6.

Chrapek 2015 {published data only}

Chrapek O, Jirkova B, Kandrnal V, Rehak J, Sin M. Treatment of central serous chorioretinopathy with beta‐blocker metipranolol. Biomedical Papers of the Medical Faculty of Palacky University in Olomouc, Czech Republic 2015;159(1):120‐3.

Demirel 2014 {published data only}

Demirel S, Ozmert E, Batioglu F. The comparison of reduced‐fluence photodynamic therapy with 577 nm yellow‐wavelength pattern micropulse laser therapy in cases with chronic central serous chorioretinopathy: short term results. Ophthalmologica 2014;232(Suppl 2):60.

Di 2013 {published data only}

Di Y, Gui DM, Yang HW, Chen XL. Changes in visual function before and after laser photocoagulation of central serous chorioretinopathy. International Eye Science 2013;13(2):336‐8.

Earl 2014 {published data only}

Earl JB, Lee CS, Yom V, Stavern GP, Abuattieh M, Chin‐Yee D, et al. Visual cycle suppression via patching in central serous chorioretinopathy. Ophthalmology 2014;121(12):2502‐4.

Fang 2013 {published data only}

Fang TB, Yan H, Xu ZR. Argon laser treatment of central serous chorioretinopathy. International Eye Science 2013;13(4):740‐2.

Feily 2009 {published data only}

Feily A, Namazi MR. The potential utility of coumarin and horse chestnut extract for treatment of central serous chorioretinopathy. Nigerian Journal of Medicine 2009;18(4):434‐5.

Haas 2004 {published data only}

Haas A, Weger M, Furschuss‐Wolff P, Bachernegg M. Photodynamic therapy in patients with central serous chorioretinopathy. Spektrum der Augenheilkunde 2004;18(2):104.

Heinrich 1974 {published data only}

Heinrich MR. Central serous retinopathy and alpha‐blockaders. Bulletin des Sociétés d'Ophtalmologie de France 1974;74(5‐6):681‐3.

Huang 2006 {published data only}

Huang Y, Wang Z, Zhang M. Clinical effectiveness of lecithin‐bound iodine on central serous chorioretinopathy following laser photocoagulation. Chinese Ophthalmic Research 2006;24(5):546‐8.

Khosla 1997 {published data only}

Khosla PK, Rana SS, Tewari HK, Azad RU, Talwar D. Evaluation of visual function following argon laser photocoagulation in central serous retinopathy. Ophthalmic Surgery and Lasers 1997;28(8):693‐7.

Koss 2012 {published data only}

Koss MJ, Beger I, Koch FH. Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy. Eye 2012;26(2):307‐14.

Kurimoto 1969 {published data only}

Kurimoto S, Fukunaga K, Momomura K. Effect of adenosine monophosphate on retinitis centralis. Nihon Ganka Kiyo 1969;20(8):841‐50.

Lee 2011 {published data only}

Lee JY, Chae JB, Yang SJ, Kim JG, Yoon YH. Intravitreal bevacizumab versus the conventional protocol of photodynamic therapy for treatment of chronic central serous chorioretinopathy. Acta Opthalmologica 2011;89(3):e293‐4.

Li 2010 {published data only}

Li XJ, Zhang JS. Intravitreal bevacizumab injection for chronic central serous chorioretinopathy. Chinese Medical Journal 2010;123(15):2145‐7.

Lim 2011 {published data only}

Lim JW, Kang SW, Kim YT, Chung SE, Lee SW. Comparative study of patients with central serous chorioretinopathy undergoing focal laser photocoagulation or photodynamic therapy. British Journal of Ophthalmology 2011;95(4):514‐7.

Liu 2009 {published data only}

Liu ZC, Li R. 532 Laser photocoagulation for the treatment of central serous chorioretinopathy. International Journal of Ophthalmology 2009;9(12):2451‐2.

Long 2011 {published data only}

Long F, Cao SJ, Wang LP, Qi F, Xiu WW. Study in krypton laser combined with compound anisodine for central serous chorioretinopathy. International Journal of Ophthalmology 2011;11(2):330‐1.

Lyons 1977 {published data only}

Lyons DE. Conservative management of central serous retinopathy. Transactions of the Ophthalmological Societies of the United Kingdom 1977;97(1):214‐6.

Mackowiakowa 1987 {published data only}

Mackowiakowa A, Pecoldowa K, Szwarcowa C. Comparison of late results of conservative treatment and laser coagulation of central serous chorioretinopathy [Porownanie wynikow odleglych po leczeniu zachowawczym i laserokoagulacji choroidoretinopatii surowiczej srodkowej]. Klinika Oczna 1987;89(4):162‐4.

Miyashita 1971 {published data only}

Miyashita S, Sakai M, Kanai A, Hayashi E. Successful treatment of central serous retinopathy by tranexamic acid injection. Nippon Ganka Gakkai Zasshi 1971;75:603‐8.

NCT01256580 {unpublished data only}

NCT01256580. Pilot study of intravitreal bevacizumab vs. combination therapy for choroidal neovascularization secondary to causes other than age‐related macular degeneration. clinicaltrials.gov/ct2/show/NCT01256580 (accessed 16 October 2015).

NCT01585441 {unpublished data only}

NCT01585441. Phase II, randomized, placebo‐controlled study for the evaluation of finasteride in the treatment of chronic central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT01585441 (accessed 16 October 2015).

Novak 1987 {published data only}

Novak MA, Singerman LJ, Rice TA. Krypton and argon laser photocoagulation for central serous chorioretinopathy. Retina 1987;7(3):162‐9.

Okamoto 2015 {published data only}

Okamoto M, Matsuura T, Ogata N. Choroidal thickness and choroidal blood flow after intravitreal bevacizumab injection in eyes with central serous chorioretinopathy. Ophthalmic Surgery Lasers and Imaging Retina2015; Vol. 46, issue 1:25‐32.

Ozdemir 2014 {published data only}

Ozdemir O, Erol MK. Morphologic changes and visual outcomes in resolved central serous chorioretinopathy treated with ranibizumab. Cutaneous and Ocular Toxicology 2014;33(2):122‐6.

Peng 2010 {published data only}

Peng QH, Peng J, Wu QL, Tan HY. Clinical study of method of activating blood and diuresis on central serous. International Journal of Ophthalmology 2010;10(7):1284‐6.

Radian 1984 {published data only}

Radian AB, Mocanu C. Enzymatic treatment of central serous retinopathy. Revista de Chirurgie, Oncologie, Radiologie, ORL, Oftalmologie, Stomatologie. Oftalmologie 1984;28(4):299‐300.

Sanchez‐Pacheco 2010 {published data only}

Sanchez‐Pacheco Tardon L, Pardo Saiz A, Nebot Martinez J, Jornet Montana S. Mifepristone as a treatment alternative to chronic serous chorioretinopathy. Farmacia Hospitalaria 2010;34(1):44‐5.

Takagi 1965 {published data only}

Takagi M. Statistic studies of retinitis centralis. Nippon Ganka Kiyo 1965;16(7):420‐3.

Tewari 1986 {published data only}

Tewari HK, Azad R, Khosla PK, Kumar A. Argon laser photocoagulation in treatment of central serous retinopathy ‐ a prospective randomized study. Indian Journal of Ophthalmology 1986;34:251‐3.

Wang 2009a {published data only}

Wang XX. Clinical analysis of argon laser in treating central serous chorioretinopathy. International Journal of Ophthalmology 2009;9(2):384‐5.

Wang 2009b {published data only}

Wang TT, Xu GX. Clinical observation of alliance application of compound anisodine and joletion in the treatment of central serous chorioretinopathy. International Journal of Ophthalmology 2009;9(6):1169‐71.

Watzke 1974 {published data only}

Watzke RC, Burton TC, Leaverton P. Ruby laser photocoagulation therapy of central serous retinopathy. A preliminary report. Modern Problems in Ophthalmology 1974;12(0):242‐6.

Watzke 1979 {published data only}

Watzke RC, Burton TC, Woolson RF. Direct and indirect laser photocoagulation of central serous choroidopathy. American Journal of Ophthalmology 1979;88(5):914‐8.

Wu 2010 {published data only}

Wu SJ, Zeng ZC. Clinical observation of Jolethin combined with argon laser for central serous chorioretinopathy. International Journal of Ophthalmology 2010;10(12):2295‐7.

Xu 2013 {published data only}

Xu B. Efficacy comparison of 577nm micro‐pulse laser and drug in the treatment of central serous chorioretinopathy. International Eye Science 2013;13(8):1688‐90.

Xu 2014 {published data only}

Xu JF, Chen KC. Treatment of juxtafoveal central serous chorioretinopathy by compound anisodine injection. International Eye Science 2014;14(4):701‐3.

Ye 2013 {published data only}

Ye J, Yang XY, Zeng S. Compound Xueshuantong capsule joint laser treating central serous chorioretinopathy. International Eye Science 2013;13(6):1160‐2.

Zhang 2014 {published data only}

Zhang J, Xue GM, Zhang QY, Cao Y. Clinical observation of laser treatment for central serous chorioretinopathy choroidal diseases and study on relationship between visual acuity with leakage location. International Eye Science 2014;14(5):872‐4.

Zheng 2013 {published data only}

Zheng TF, Qin YY. Hyperbaric oxygen therapy combined with jolethin in treating central serous chorioretinopathy. International Eye Science 2013;13(10):2124‐6.

EUCTR2009‐017959‐98‐NL {unpublished data only}

EUCTR2009‐017959‐98‐NL. Early treatment of patients with central serous retinopathy: a randomized controlled trial ‐ CSR & PDT. apps.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2009‐017959‐98‐NL (accessed 16 October 2015).

JPRN‐UMIN000005372 {unpublished data only}

JPRN‐UMIN000005372. Study on the effects of supplements containing lutein on spontaneous resolution in eyes with chronic central serous chorioretinopathy. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN‐UMIN000005372 (accessed 16 October 2015).

NCT01019668 {unpublished data only}

NCT01019668. Central serous chorioretinopathy treated by modified photodynamic therapy. clinicaltrials.gov/ct2/show/NCT01019668 (accessed 16 October 2015).

NCT01552044 {unpublished data only}

NCT01552044. Effect of spironolactone in treating chronic non‐resolutive central serous chorioretinitis [Evaluation de la spironolactone dans le traitement des choriorétinites séreuses centrales non résolutives à trois mois]. clinicaltrials.gov/ct2/show/NCT01552044 (accessed 16 October 2015).

NCT01630863 {unpublished data only}

NCT01630863. The safe effective light dose of photodynamic therapy for chronic central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT01630863 (accessed 16 October 2015).

NCT01797861 {unpublished data only}

Breukink MB, Downes SM, Querques G, van Dijk EH, den Hollander AI, Blanco‐Garavito R, et al. Comparing half‐dose photodynamic therapy with high‐density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy (the PLACE trial): study protocol for a randomized controlled trial. TRIALS 2015;16:419.
NCT01797861. A prospective randomized controlled multicentre trial comparing half‐dose photodynamic therapy (PDT) with high‐density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy (CSC). clinicaltrials.gov/ct2/show/NCT01797861 (accessed 16 October 2015).

NCT01971190 {unpublished data only}

NCT01971190. Efficacy and safety of intravitreal aflibercept injection for subacute central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT01971190 (accessed 16 October 2015).

NCT01982383 {unpublished data only}

NCT01982383. A prospective study of the use of micropulse 577nm laser treatment in central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT01982383 (accessed 16 October 2015).

NCT01990677 {unpublished data only}

NCT01990677. Eplerenone for the treatment of central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT01990677 (accessed 16 October 2015).

NCT02153125 {unpublished data only}

NCT02153125. Eplerenone for the treatment of chronic central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT02153125 (accessed 16 October 2015).

NCT02215330 {unpublished data only}

NCT02215330. A randomized, double‐masked, placebo controlled study of the beneficial effects of eplerenone on central serous chorioretinopathy. clinicaltrials.gov/ct2/show/NCT02215330 (accessed 16 October 2015).

NCT02354170 {unpublished data only}

NCT02354170. Short‐term oral mifepristone for central serous chorioretinopathy. A placebo‐controlled dose ranging study of mifepristone in the treatment of CSC (STOMP‐CSC). clinicaltrials.gov/ct2/show/NCT02354170 (accessed 16 October 2015).

Ahad 2006

Ahad MA, Chua CN, Evans NM. Central serous chorioretinopathy associated with testosterone therapy. Eye 2006;20(4):503‐5.

Baran 2005

Baran NV, Gürlü VP, Esgin H. Long‐term macular function in eyes with central serous chorioretinopathy. Clinical and Experimental Ophthalmology 2005;33(4):369‐72.

Bousquet 2013

Bousquet E, Beydoun T, Zhao M, Hassan L, Offret O, Behar‐Cohen F. Mineralocorticoid receptor antagonism in the treatment of chronic central serous chorioretinopathy: a pilot study. Retina 2013;33(10):2096‐102.

Bouzas 2002

Bouzas EA, Karadimas P, Pournaras CJ. Central serous chorioretinopathy and glucocorticoids. Survey of Ophthalmology 2002;47(5):431‐48.

Bucher 1997

Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta‐analysis of randomized controlled trials. Journal of Clinical Epidemiology 1997;50:683‐91.

Cardillo Piccolino 2003

Cardillo Piccolino F, Eandi CM, Ventre L, Rigault de la Longrais RC, Grignolo FM. Photodynamic therapy for chronic central serous chorioretinopathy. Retina 2003;23(6):752‐63.

Cassin 2006

Cassin B. Dictionary of Eye Terminology. 5th Edition. Gainesville, Florida: Triad Publishing Company, 2006.

Castro‐Correia 1992

Castro‐Correia J, Countinho MF, Rosas V, Maia J. Long‐term follow‐up of central serous retinopathy in 150 patients. Documenta Ophthalmologica 1992;81(4):379‐86.

Chaimani 2013

Chaimani A, Higgins JP, Mavridis D, Spyridonos P, Salanti G. Graphical tools for network meta‐analysis in STATA. PLoS One 2013;8:e76654.

Chan 2003

Chan WM, Lam DS, Lai TY, Yuen KS, Liu DT, Chan CK, et al. Treatment of choroidal neovascularization in central serous chorioretinopathy by photodynamic therapy with verteporfin. American Journal of Opthalmology 2003;136(5):836‐45.

Chen 2008

Chen SN, Hwang JF, Tseng LF, Lin CJ. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage. Ophthalmology 2008;115(12):2229‐34.

Chou 2000

Chou SC, Lin JD. Long‐term effects of ketoconazole in the treatment of residual or recurrent Cushing's disease. Endocrine Journal 2000;47(4):401‐6.

Chung 2013

Chung YR, Seo EJ, Lew HM, Lee KH. Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta‐analysis and review. Eye 2013;27:1339‐46.

Clark 2008

Clark JA, Flick RB, Pai LY, Szalayova I, Key S, Conley RK, et al. Glucocorticoid modulation of tryptophan hydroxylase‐2 protein in raphe nuclei and 5‐hydroxytryptophan concentrations in frontal cortex of C57/Bl6 mice. Molecular Psychiatry 2008;13(5):498‐506.

Cotticelli 2006

Cotticelli L, Borrelli M, D'Alessio AC, Menzione M, Villani A, Piccolo G, et al. Central serous chorioretinopathy and Helicobacter pylori . European Journal of Ophthalmology 2006;16(2):274‐8.

Covidence

Covidence. www.covidence.org (accessed 20 April 2015).

Cox 1988

Cox SN, Hay E, Bird AC. Treatment of chronic macular edema with acetazolamide. JAMA Ophthalmology 1988;106(9):1190‐5.

FDA 2015

Drugs@FDA. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cder/drugsatfda/ (accessed 25 August 2015).

Forooghian 2011

Forooghian F, Meleth AD, Cukras C, Chew EY, Wong WT, Meyerle CB. Finasteride for chronic central serous chorioretinopathy. Retina 2011;31(4):766‐71.

Gass 1967

Gass JD. Pathogenesis of disciform detachment of the neuroepithelium. American Journal of Ophthalmology 1967;63(3):S1‐139.

Giusti 2004

Giusti C. Association of Helicobacter pylori with central serous chorioretinopathy: hypotheses regarding pathogenesis. Medical Hypotheses 2004;63(3):524‐7.

Glanville 2006

Glanville JM, Lefebvre C, Miles JN, Camosso‐Stefinovic J. How to identify randomized controlled trials in MEDLINE: ten years on. Journal of the Medical Library Association 2006;94(2):130‐6.

Grieshaber 2007

Grieshaber MC, Staub JJ, Flammer J. The potential role of testosterone in central serous chorioretinopathy. British Journal of Ophthalmology 2007;91(1):118‐9.

Guengerich 1999

Guengerich FP. Cytochrome P‐450 3A4: regulation and role in drug metabolism. Annual Review of Pharmacology and Toxicology 1999;39:1‐17.

Guyatt 2011

Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. Journal of Clinical Epidemiology 2011;64:380‐2.

Haimovici 2004

Haimovici R, Koh S, Gagnon DR, Lehrfeld T, Wellik S, Central Serous Chorioretinopathy Case‐Control Study Group. Risk factors for central serous chorioretinopathy: a case‐control study. Ophthalmology 2004;111(2):244‐9.

Higgins 2003

Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60.

Higgins 2011

Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.

Higgins 2012

Higgins JPT, Jackson D, Barrett JK, Lu G, Ades AE, White IR. Consistency and inconsistency in network meta‐analysis: concepts and models for multi‐arm studies. Research Synthesis Methods 2012;3:98‐110.

Hofstetter 2000

Hofstetter WH, Griffin JR, Berman MS, Everson RW. Visual Science and Related Clinical Terms. 5th Edition. Woburn: Butterworth‐Heinemann, 2000.

Iijima 1999

Iijima H, Iida T, Murayama K, Imai M, Gohdo T. Plasminogen activator inhibitor 1 in central serous chorioretinopathy. American Journal of Ophthalmology 1999;127(4):477‐8.

Jampol 2002

Jampol LM, Weinreb R, Yannuzzi L. Involvement of corticosteroids and catecholamines in the pathogenesis of central serous chorioretinopathy: a rationale for new treatment strategies. Ophthalmology 2002;109(10):1765‐6.

Kim 2009

Kim SW, Oh J, Oh IK, Huh K. Retinal pigment epithelial tear after half fluence PDT for serous pigment epithelial detachment in central serous chorioretinopathy. Ophthalmic Surgery, Lasers and Imaging Retina 2009;40(3):300‐3.

Kitzmann 2008

Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP. The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980‐2002. Ophthalmology 2008;115(1):169‐73.

Klein 1974

Klein ML, Van Buskirk EM, Friedman E, Gragoudas E, Chandra S. Experience with nontreatment of central serous choroidopathy. Archives of Ophthalmology 1974;91(4):247‐50.

Lai 2006

Lai TY, Chan WM, Li H, Lai RY, Liu DT, Lam DS. Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. British Journal of Ophthalmology 2006;90(7):869‐74.

Lim 2014

Lim JI, Glassman AR, Aiello LP, Chakravarthy U, Flaxel CJ, Spaide RF. Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 2014;121:1073‐8.

Loo 2002

Loo RH. Factors associated with reduced visual acuity during long‐term follow‐up of patients with idiopathic central serous chorioretinopathy. Retina 2002;22(1):19‐24.

Ma 2014

Ma J, Meng N, Xu X, Zhou F, Qu Y. System review and meta‐analysis on photodynamic therapy in central serous chorioretinopathy. Acta Ophthalmologica 2014;92:e594‐601.

Maalej 2014

Maalej A, Khallouli A, Wathek C, Rannen R, Gabsi S. Central serous chorioretinopathy: clinical‐anatomic correlations. Journal Français d'Ophtalmologie 2014;37(10):787‐95.

Maruko 2010

Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology 2010;117(9):1792‐9.

Meyerle 2007

Meyerle CB, Freund KB, Bhatnagar P, Shah V, Yannuzzi LA. Ketoconazole in the treatment of chronic idiopathic central serous chorioretinopathy. Retina 2007;27(7):943‐6.

Mitsui 1969

Mitsui Y, Matsubara M, Kanagawa M. Xenon light‐exposure as a treatment of central serous retinopathy (a preliminary report). Nippon Ganka Kiyo 1969;20(3):291‐4.

Montero 2005

Montero JA, Ruiz‐Moreno JM. Optical coherence tomography characterisation of idiopathic central serous chorioretinopathy. British Journal of Ophthalmology 2005;89(5):562‐4.

Mudvari 2007

Mudvari SS, Goff MJ, Fu AD, McDonald HR, Johnson RN, Ai E. The natural history of pigment epithelial detachment associated with central serous chorioretinopathy. Retina 2007;27(9):1168‐73.

Nicholson 2013

Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: update on pathophysiology and treatment. Survey of Ophthalmology 2013;58(2):103‐26.

Prunte 1996

Prunte C, Flammer J. Choriodal capillary and venous congestion in central serous chorioretinopathy. American Journal of Ophthalmology 1996;121(1):26‐34.

Puhan 2014

Puhan MA, Schünemann HJ, Murad MH, Li T, Brignardello‐Petersen R, Singh JA, et al. A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta‐analysis. BMJ 2014;349:g5630.

Quin 2013

Quin G, Liew G, Ho I, Gillies M, Fraser‐Bell S. Diagnosis and interventions for central serous chorioretinopathy: review and update. Clinical and Experimental Ophthalmology 2013;41(2):187‐200.

Reibaldi 2010

Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S, et al. Standard‐fluence versus low‐fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. American Journal of Ophthalmology 2010;149(2):307‐15.

RevMan 2014 [Computer program]

The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.

Ricci 2004

Ricci F, Missiroli F, Cerulli L. Indocyanine green dye‐enhanced micropulsed diode laser: a novel approach to subthreshold RPE treatment in a case of central serous chorioretinopathy. European Journal of Ophthalmology 2004;14(1):74‐82.

Schlötzer‐Schrehardt 2002

Schlötzer‐Schrehardt U, Viestenz A, Naumann GO, Laqua H, Michels S, Schmidt‐Erfurth U. Dose‐related structural effects of photodynamic therapy on choroidal and retinal structures of human eyes. Graefe's Archive for Clinical and Experimental Ophthalmology 2002;240(9):748‐57.

Schmidt‐Erfurth 2002

Schmidt‐Erfurth U, Michels S, Barbazetto I, Laqua H. Photodynamic effects on choroidal neovascularization and physiological choroid. Investigative Ophthalmology and Visual Science 2002;43(3):830‐41.

Shuler 2006

Shuler RK, Mruthyunjaya P. Diagnosing and managing central serous chorioretinopathy. EyeNet Magazine, February 2006. Available at www.aao.org/publications/eyenet/200602/pearls.cfm (accessed 13 March 2015).

Sivaprasad 2010

Sivaprasad S, Elagouz M, McHugh D, Shona O, Dorin G. Micropulsed diode laser therapy: evolution and clinical applications. Survey of Ophthalmology 2010;55(6):516‐30.

Sterne 2011

Sterne JAC, Egger M, Moher D. Chapter 10: Addressing reporting biases. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.

Systematic Review Data Repository

Systematic Review Data Repository (SRDR). srdr.ahrq.gov/ (accessed 20 April 2015).

Wang 2008

Wang M, Munch IC, Hasler PW, Prunte C, Larsen M. Central serous chorioretinopathy. Acta Opthalmologica 2008;86(2):126‐45.

White 2009

White IR. Multivariate random‐effects meta‐analysis. Stata Journal 2009;9:40‐56.

White 2011

White IR. Multivariate random‐effects meta‐regression: updates to mvmeta. Stata Journal 2011;11:255‐70.

White 2012

White IR, Barrett JK, Jackson D, Higgins JPT. Consistency and inconsistency in network meta‐analysis: model estimation using multivariate meta‐regression. Research Synthesis Methods 2012;3:111‐25.

Winquist 1995

Winquist EW, Laskey J, Crump M, Khamsi F, Shepherd FA. Ketoconazole in the management of paraneoplastic Cushing's syndrome secondary to ectopic adrenocorticotropin production. Journal of Clinical Oncology 1995;13(1):157‐64.

Yannuzzi 1987

Yannuzzi LA. Type‐A behavior and central serous chorioretinopathy. Retina 1987;7(2):111‐31.

Yanoff 2013

Yanoff M, Duker J. Ophthalmology. 4th Edition. Saunders, 2013.

Zhao 2012

Zhao M, Célérier I, Bousquet E, Jeanny JC, Jonet L, Savoldelli M, et al. Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy. Journal of Clinical Investigation 2012;122(7):2672‐9.

Referencias de otras versiones publicadas de esta revisión

Jump to:

Salehi 2015

Salehi M, Wenick A, Law HA, Evans J, Gehlbach P. Interventions for central serous chorioretinopathy: a network meta‐analysis. Cochrane Database of Systematic Reviews 2015, Issue 8. [DOI: 10.1002/14651858.CD011841]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Jump to:

Bae 2011

Methods

Study design: parallel randomized controlled trial

Number randomized:

16 eyes of NR participants in anti‐VEGF group

18 eyes of NR participants in PDT group

Exclusions after randomization:

0 in anti‐VEGF group

0 in PDT group

Number analyzed:

16 eyes of NR participants in anti‐VEGF group

18 eyes of NR participants in PDT group

Unit of analysis: mixed, some participants had 1 eye included, some participants had both eyes included

Losses to follow‐up:

2 eyes of participants in anti‐VEGF group

0 in PDT group

How were missing data handled?: NA

Power calculation: power = 80% and sample size = 34 eyes total (17 eyes in each group)

Participants

Country: South Korea
Mean age (SD) (years):

50.8 (7.7) overall
48.9 (7.5) in anti‐VEGF group
51.4 (8.2) in PDT group
Gender (%): 28 men (82%) and 6 women (18%) in Total group
13 men (81%) and 3 women (19%) in anti‐VEGF group

15 men (83%) and 3 women (17%) in PDT group
Participants with chronic CSC were included as defined as: "chronic CSC with visual disturbance persisting for >6 months or recurrent CSC. Recurrent CSC was defined as the recurrence of serous retinal detachment on optical coherence tomography (OCT) associated with visual symptoms after complete recovery of ocular manifestations; the first episode occurred >6 months before screening and the current episode persisted >3 months with sustained SRF on OCT"
Inclusion criteria: BCVA 0‐1.0 logMAR; presence of SFF persisting for > 3 months on OCT; presence of multifocal/diffuse RPE decompensation with leakage on the FA; and choroidal vascular hyperpermeability and abnormal dilation of the choroidal vasculature on ICGA

Exclusion criteria: history of treatment including PDT, focal laser photocoagulation, intravitreal injection of steroid or anti‐VEGF agent in the study eye; evidence of CNV or polypoidal choroidal vasculopathy; any other ocular diseases that can affect visual acuity, including diabetic retinopathy, retinal vascular occlusion, or ocular inflammatory diseases; media opacity that interferes with adequate image acquisition; history of any intraocular surgery except uncomplicated cataract surgery > 3 months before enrollment; history of systemic steroid or anti‐VEGF treatment in the preceding 12 months; uncontrolled glaucoma with intraocular pressure > 21 mm Hg despite treatment; uncontrolled hypertension, diabetes, or history of cerebrovascular accident or myocardial infarction; and pregnancy
Equivalence of baseline characteristics: NR

Interventions

Intervention: anti‐VEGF (ranibizumab)

Dose: 0.5 mg/0.05 mL

Frequency: baseline, 1 and 2 months

Control: low‐fluence PDT

Light dose: 25 J/cm2

Verteporfin concentration: 6 mg/m2

Outcomes

Length of follow‐up: 12 months
Primary outcome, as defined in study reports: primary efficacy outcome was proportion of eyes that maintained the complete absorption of SRF until 12 months without any rescue treatment
Secondary outcomes, as defined in study reports: serial changes from baseline of mean change in logMAR BCVA; mean change in CRT obtained by OCT; proportion of eyes with resolved leakage on FA; proportion of eyes with resolved choroidal hyperpermeability on ICGA; and fluid‐free interval, which was defined as the interval between the time when the SRF was completely absorbed without any rescue treatment and when re‐accumulation of the fluid occurred
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 3, 6, 9, and 12 months

Notes

Full study name: Low‐fluence photodynamic therapy versus ranibizumab for chronic central serous chorioretinopathy: one‐year results of a randomized trial
Type of study: published full‐text
Funding sources: Novartis Korea, Seoul, Korea
Disclosures of interest: reported explicitly none of the authors had any financial relationship

Trial registry: NCT01325181 (clinicaltrials.gov)
Study period: July 2009 to September 2012 (as reported in the trial registry)

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"Patients were randomized to receive low‐fluence PDT or the intravitreal injections of ranibizumab with an equal allocation ratio by means of permuted block randomization" p. 559

Allocation concealment (selection bias)

Unclear risk

"Subjects and the treating ophthalmologist (S.H.B.) were not masked to the treatment modalities" p. 559

Unclear if the allocation was masked before enrollment

Masking of participants and personnel (performance bias)

High risk

"Subjects and the treating ophthalmologist (S.H.B.) were not masked to the treatment modalities" p. 559

Masking of outcome assessment (detection bias)

Low risk

"The investigator (J.H.) and the other examiners for BCVA measurement, OCT, FA, and ICGA were masked to treatment allocation" p. 559

Incomplete outcome data (attrition bias)
All outcomes

Low risk

2/34 participants (< 10%) lost to follow‐up

Selective reporting (reporting bias)

Low risk

All outcomes on trial registry entry reported in paper

Other bias

High risk

Received industry funding (Novartis Korea, Seoul, Korea). Stated that "the sponsor or funding organization had no role in the design or conduct of this research. No conflicting relationship exists for any author"

Boscia 2008

Methods

Study design: unclear ‐ refers only to eyes
Number randomized:

8 eyes of NR participants in PDT group
8 eyes of NR participants in observation group
Exclusions after randomization: not reported
Number analyzed: NR
Unit of analysis: unclear
Losses to follow‐up: NR
How were missing data handled?: NA
Power calculation: NR

Participants

Country: Italy (probably)
Mean age (SD) (years):

NR for overall and by group

Gender (%): did not report number of men and women overall or by group

Participants with chronic CSC were included as defined as: not defined
Inclusion criteria: BCVA 0.2‐1 logMAR; presence of SRF or serous pigment epithelial detachment on OCT (or both) without regression for ≥ 3 months, RPE leakage on FA and choroidal vascular hyperpermeability on confocal SLO‐ICGA

Exclusion criteria: any previous treatment for CSC; evidence of other chorioretinal disorders; media opacities; and treatment with systemic steroids
Equivalence of baseline characteristics: NR

Interventions

Intervention: low‐fluence PDT

light dose: 25 J/cm2

Verteporfin concentration: NR
Control: observation

Outcomes

Length of follow‐up: 24 weeks
Primary outcome, as defined in study reports: far BCVA (logMAR, using ETDRS charts) and near BCVA (logMAR, using MNRead Acuity Charts); CMT (OCT3, Zeiss‐Humphrey)
Secondary outcomes, as defined in study reports: macular sensitivity and stability of fixation determined using microperimetry (Nidek MP1)
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 4, 12, and 24 weeks

Notes

Full study name: Low fluence photodynamic therapy in chronic central serous chorioretinopathy: blind randomized clinical trial of efficacy and safety
Type of study: published abstract
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Contacted study authors and received no response

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

High risk

Different groups and the study described as being "blind" but no information on masking

Masking of outcome assessment (detection bias)

High risk

Different groups and the study described as being "blind" but no information on masking

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Brancato 1994

Methods

Study design: cross‐over randomized controlled trial
Number randomized:

NR eyes of 25 participants in total,

By group NR
Exclusions after randomization: NR
Number analyzed: NR
Unit of analysis: unclear
Losses to follow‐up: NR
How were missing data handled?: NA
Power calculation: NR
Unusual study design: "two weeks of treatment with propranolol, then one week of wash‐out; two weeks of treatment with nimodizin and again one of wash‐out; two weeks of placebo treatment"

Participants

Participants with both acute or chronic CSC were enrolled

Country: NR
Inclusion criteria: NR
Equivalence of baseline characteristics: unclear

Interventions

Intervention: beta‐blocker (propranolol)

Dose: NR

Frequency: NR

Duration: NR
Control: calcium antagonist (nimodizin)

Dose: NR

Frequency: NR

Duration: NR

Outcomes

Length of follow‐up: NR
Primary outcome: no outcomes defined

Secondary outcomes: no outcomes defined
Adverse events reported: no
Intervals at which outcomes assessed: NR

Notes

Full study name: Treatment of central serous chorioretinopathy with beta‐blockers and calcium antagonists
Type of study: published abstract
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Contacted study authors and received no response

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

Unclear risk

Both interventions were pills but no information on how similar the pills were

Masking of outcome assessment (detection bias)

Unclear risk

Both interventions were pills but no information on how similar the pills were

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Browning 1993

Methods

Study design: parallel randomized controlled trial
Number randomized:

NR eyes of 8 participants in beta‐blocker group
NR eyes of 8 participants in placebo group
Exclusions after randomization: NR
Number analyzed: NR
Unit of analysis: individual
Losses to follow‐up: NR
How were missing data handled?: NR
Power calculation: NR

Participants

Country: US

Mean age (SD) (years):

41.5 (NR) in total
41 (NR) in beta‐blocker group
42 (NR) in placebo group
Gender (%):

9 men (56%) and 7 women (44%) in total
4 men (50%) and 4 women (50%) in beta‐blocker group
5 men (63%) and 3 women (38%) in placebo group

Type of CSC not specified
Inclusion criteria: "all patients had serous retinal detachments and consistent fluorescein angiograms. no patient had vitreous cells, uncontrolled hypertension, recent pregnancy, or other causes of serous retinal detachment"
Equivalence of baseline characteristics: NR

Interventions

Intervention: beta‐blocker (nadolol)

Dose: 40 mg

Frequency: daily

Duration: NR

Control: placebo

Outcomes

Length of follow‐up: 4 months
Primary and secondary outcomes not differentiated
Adverse events reported: no
Intervals at which outcomes assessed: 4 months

Notes

Full study name: Nadolol in the treatment of central serous retinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

"I evaluated the effect of the nonselective beta‐blocker nadolol in a prospective, randomized, double‐masked trial" p. 770

No further information on sequence generation

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

Low risk

Placebo‐controlled trial

Masking of outcome assessment (detection bias)

Low risk

Placebo‐controlled trial

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Chan 2006

Methods

Study design: parallel randomized controlled trial
Number randomized:

15 eyes of 15 participants in total

By group NR
Exclusions after randomization: NR
Number analyzed: NR
Unit of analysis: individual
Losses to follow‐up: NR
How were missing data handled?: NR
Power calculation: NR

Participants

Type of CSC not specified

Country: US

Mean age (SD) (years):

Total and by group NR
Gender (%): total and by group NR

Inclusion criteria: NR
Equivalence of baseline characteristics: unclear

Interventions

Intervention: low‐dose transpupillary thermotherapy

Control: sham laser

Outcomes

Length of follow‐up: 3 months
Primary and secondary outcomes not differentiated

Outcomes: proportion of eyes with resolved CSC
Adverse events reported: no
Intervals at which outcomes assessed: 3 months

Notes

Full study name: Low‐dose transpupillary thermotherapy for the treatment of central serous chorioretinopathy
Type of study: published abstract
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Contacted study authors who were unable to provide a reference to the full‐text

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

"Fifteen eyes of 15 patients with CSR [CSC] were randomly assigned"

No further information on sequence generation

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

Unclear risk

Control group had sham therapy but no details on how this was done

Masking of outcome assessment (detection bias)

Unclear risk

Control group had sham therapy but no details on how this was done

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Chan 2008

Methods

Study design: parallel randomized controlled trial
Number randomized:

42 eyes of 42 participants in PDT group
21 eyes of 21 participants in placebo group
Exclusions after randomization:

0 in PDT group
0 in placebo group
Number analyzed:

39 eyes of 39 participants in PDT group
19 eyes of 19 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

3 eyes of 3 participants in PDT group
2 eyes of 2 participants in placebo group
How were missing data handled?: NR
Power calculation: power = 85% and sample size = yes, power = 85% and sample size = 63 participants total (42 participants in PDT group and 21 participants in placebo group)

Participants

Participants with acute CSC were included and defined as: acute symptomatic CSC of ≤ 3 months' duration

Country: China
Mean age (SD) (years):

41.0 (6.7) in total
40.3 (5.8) in PDT group
42.4 (8.4) in placebo group
Gender (%):

54 men (86%) and 9 women (14%) in total
38 men (90%) and 4 women (10%) in PDT group
16 men (76%) and 5 women (24%) in placebo group

Inclusion criteria: people with BCVA ≥ 20/200; presence of SRF involving the fovea on OCT; presence of active angiographic leakage on FA caused by CSC but not CNV or other diseases; and abnormal dilated choroidal vasculature and other features on ICGA consistent with the diagnosis of CSC
Equivalence of baseline characteristics: NR

Interventions

Intervention: 50% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 3 mg/m2

Control: placebo (30 mL normal saline infused instead of verteporfin, and laser applied in the same manner as in the verteporfin group)

Outcomes

Length of follow‐up: 12 months
Primary outcome, as defined in study reports: proportion of eyes with complete absorption of SRF at 12 months
Secondary outcomes, as defined in study reports: serial changes in logMAR BCVA, OCT CFT, FA, and ICGA, and systemic and ocular complications during the study
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 3, 6, 9, and 12 months

Notes

Full study name: Half‐dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one‐year results of a randomized controlled trial
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: "Dr Lai has served as a consultant to an advisory board of Novartis, Inc"

Trial registry: not registered
Study period: December 2004 to December 2005, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The randomization sequence was generated using a computerized randomization table kept centrally by a research nurse, and the group allocation was performed before drug preparation and infusion" p. 1757

Allocation concealment (selection bias)

Low risk

"The randomization sequence was generated using a computerized randomization table kept centrally by a research nurse, and the group allocation was performed before drug preparation and infusion. All patients and investigators were masked to the treatment allocation group by wrapping the infusion syringes externally with aluminum foil" p. 1757

Masking of participants and personnel (performance bias)

Low risk

"All patients and investigators were masked to the treatment allocation group by wrapping the infusion syringes externally with aluminum foil" p. 1757

Masking of outcome assessment (detection bias)

Low risk

"All patients and investigators were masked to the treatment allocation group by wrapping the infusion syringes externally with aluminum foil" p. 1757

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Overall 5/58 participants (< 10%) were lost to follow‐up; 3/39 PDT group lost to follow‐up; 2/19 of placebo group

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Source of funding not reported. A conflict of interest was declared but only for 1 of the 5 authors and not the first author: "Dr Lai has served as a consultant to an advisory board of Novartis, Inc. All other authors have no financial interest to declare"

Coskun 2014

Methods

Study design: parallel randomized controlled trial
Number randomized:

8 eyes of 8 participants in anti‐VEGF group

7 eyes of 7 participants in PDT group
Exclusions after randomization: NR
Number analyzed:

8 eyes of 8 participants in anti‐VEGF group

7 eyes of 7 participants in PDT group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up: NR
How were missing data handled?: NR
Power calculation: NR

Participants

Country: Turkey
Mean age (SD) (years):

NR in total

46.5 (11.5) in anti‐VEGF group
56.1 (7.5) in PDT group
Gender (%): NR

Participants with chronic CSC were included and defined as: eyes with symptomatic chronic CSC (duration 6 months)
Inclusion criteria: eyes with symptomatic chronic CSC
Equivalence of baseline characteristics: NR

Interventions

Intervention: 50% PDT + anti‐VEGF (bevacizumab)

Light dose: 50 J/cm2

Verteporfin concentration: 3 mg/m2

Bevacizumab dose: 1.25 mg

Bevacizumab duration: single dose, 3 days after PDT

Control: 50% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 3 mg/m2

Outcomes

Length of follow‐up: 12 months
Primary and secondary outcomes not differentiated

Outcomes: time to CSC resolution; BCVA; CMT
Adverse events reported: no
Intervals at which outcomes assessed: 1, 3, 6, and 12 months

Notes

Full study name: Combined half dose photodynamic therapy with verteporfin and intravitreal bevacizumab for chronic central serous chorioretinopathy
Type of study: published abstract
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

Groups different and no mention of masking

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Dang 2013

Methods

Study design: parallel randomized controlled trial
Number randomized:

32 eyes of 32 participants in Helicobacter pylori treatment group
32 eyes of 32 participants in placebo group
Exclusions after randomization: NR
Number analyzed:

27 eyes of 27 participants in H. pylori group
26 eyes of 26 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

5 eyes of 5 participants in H. pylori group
6 eyes of 6 participants in placebo group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: China
Mean age (SD) (years):

NR in total
35.66 (5.47) in H. pylori group
34.85 (5.53) in placebo group
Gender (%):

43 men (81%) and 10 women (19%) in total
22 men (81%) and 5 women (19%) in H. pylori group
21 men (81%) and 5 women (19%) in placebo group
Participants with chronic CSC were included and defined as: duration > 12 weeks
Inclusion criteria: single idiopathic leakage detected by FA excluding any other diseases; SRF confirmed by OCT (3D OCT‐2000; TOPCON Corporation, Tokyo, Japan); H. pylori infection diagnosed according to a specific protocol
1 pupillary diameter); diffused retinal pigment epitheliopathy; aged < 20 years old and > 70 years old; and pregnancy, steroid use, and any other systemic diseases
Equivalence of baseline characteristics: NR

Interventions

Intervention:Helicobacter pylori treatment

Drug (dose): omeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1000 mg

Frequency: twice a day

Duration: 14 days
Control: placebo

Outcomes

Length of follow‐up: 12 weeks
Primary and secondary outcomes not differentiated
Outcomes: disappearance rate of SRF; BCVA; and central retinal sensitivity
Adverse events reported: yes, but not descriptive; "during the follow‐up visit, no systemic or ocular adverse events occurred" p. 358
Intervals at which outcomes assessed: 2, 4, 8, and 12 weeks

Notes

Full study name: The effect of eradicating Helicobacter pylori on idiopathic central serous chorioretinopathy patients
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: not registered
Study period: September 2010 to December 2012, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"Participants were randomly assigned through a web‐based data entry system maintained at the Data Coordinating Center (The MEDABC Corporation, Zhengzhou, Henan, People's Republic of China), with equal probability of receiving either H. pylori eradication (referred to as the active treatment group) or placebo drugs (referred to as the control group) using a permuted‐block design with random block sizes" p. 356

Allocation concealment (selection bias)

Low risk

Participants were randomly assigned through a web‐based data entry system maintained at the Data Coordinating Center (The MEDABC Corporation, Zhengzhou, Henan, People's Republic of China), with equal probability of receiving either H. pylori eradication (referred to as the active treatment group) or placebo drugs (referred to as the control group) using a permuted‐block design with random block sizes" p. 356

Masking of participants and personnel (performance bias)

Low risk

"The control group received an identical placebo that was the same color, size, and had the same identification name as the treatment. The placebos were taken in the same manner as the study drugs. Both drugs were also in identical opaque bottles and prepared by one nonclinician research assistant" p. 356

Masking of outcome assessment (detection bias)

Low risk

"The control group received an identical placebo that was the same color, size, and had the same identification name as the treatment. The placebos were taken in the same manner as the study drugs. Both drugs were also in identical opaque bottles and prepared by one nonclinician research assistant" p. 356

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

"A total of 64 eyes in 64 patients were enrolled and randomized equally into two groups. Eleven eyes (17.18%) were lost to follow‐up or did not yield enough data (five eyes in the active treatment group and six eyes in the control group). A total of 53 eyes (82.81%) were included in the study." p. 357

Although similar drop‐outs loss to follow‐up was approaching 20% and no information on reasons for loss to follow‐up

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry not available for comparison

Other bias

Low risk

Source of monetary support not reported and conflict of interest was declared: "the authors report no conflicts of interest in this work"

Kianersi 2008

Methods

Study design: parallel randomized controlled trial
Number randomized:

30 eyes of 30 participants in beta‐blocker group
30 eyes of 30 participants in placebo group
Exclusions after randomization:

0 in beta‐blocker group
0 in placebo group
Number analyzed:

30 eyes of 30 participants in beta‐blocker group
30 eyes of 30 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in beta‐blocker group
0 in placebo group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: Iran
Mean age (SD) (years):

35 (8) in total
34 (7) in beta‐blocker group
36 (8) in placebo group
Gender (%):

44 men (73%) and 16 women (27%) in total
23 men (77%) and 7 women (23%) in beta‐blocker group
21 men (70%) and 9 women (30%) in placebo group
The type of CSC was not specified
Inclusion criteria: no contraindication for propranolol use; no other eye disease such as cataract, retinal disorders, etc., which causes diminish visual activity; no indication for laser therapy
Equivalence of baseline characteristics: NR

Interventions

Intervention: beta‐blocker (propranolol)

Dose: 20 mg

Frequency: twice daily

Duration: NR
Control: placebo

Outcomes

Length of follow‐up: 12 months
Primary and secondary outcomes not differentiated
Outcomes: psychological tension; subretinal fleck; recurrence of CSC; visual acuity
Adverse events reported: yes, laser therapy; kidney transplantation; multiple sclerosis; kidney disease caused by steroid use
Intervals at which outcomes assessed: weekly for 1 year

Notes

Full study name: Effects of propranolol in patients with central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: 2003 to 2004, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"Patients met the inclusion criteria were referred to the second author (FF), and according to the table of random numbers, they were assigned randomly in two groups; half of patients received propranolol (treatment group) and the other half received placebo with the shape and color similar to propranolol" p. 104

Allocation concealment (selection bias)

Unclear risk

"Patients met the inclusion criteria were referred to the second author (FF), and according to the table of random numbers, they were assigned randomly in two groups; half of patients received propranolol (treatment group) and the other half received placebo with the shape and color similar to propranolol" p. 104

Masking of participants and personnel (performance bias)

Low risk

"Patients met the inclusion criteria were referred to the second author (FF), and according to the table of random numbers, they were assigned randomly in two groups; half of patients received propranolol (treatment group) and the other half received placebo with the shape and color similar to propranolol" p. 104

Masking of outcome assessment (detection bias)

Unclear risk

"Patients met the inclusion criteria were referred to the second author (FF), and according to the table of random numbers, they were assigned randomly in two groups; half of patients received propranolol (treatment group) and the other half received placebo with the shape and color similar to propranolol" p. 104

This suggests that the research staff may have been unmasked to the treatment assignment

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not clearly reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Kim 2013

Methods

Study design: parallel randomized controlled trial
Number randomized:

25 eyes of 25 participants in anti‐VEGF group
25 eyes of 25 participants in placebo group
Exclusions after randomization: NR
Number analyzed:

20 eyes of 20 participants in anti‐VEGF group
20 eyes of 20 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

5 eyes of 5 participants in anti‐VEGF group
5 eyes of 5 participants in placebo group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: South Korea
Mean age (SD) (years):

43.05 (7.46) in anti‐VEGF group
41.40 (7.80) in placebo group
Gender (%):

22 men (55%) and 18 women (45%) in total
12 men (60%) and 8 women (40%) in anti‐VEGF group
10 men (50%) and 10 women (50%) in placebo group
Participants with acute CSC were included and defined as: < 3 months' duration
Inclusion criteria: NR

Exclusion criteria: people who had received any previous treatment, including PDT or focal thermal laser photocoagulation for CSC, or who had evidence of CNV, polypoidal choroidal vasculopathy, or other maculopathy on fundus examination, FA, or ICGA

Equivalence of baseline characteristics: NR

Interventions

Intervention: anti‐VEGF (ranibizumab)

Dose: 0.5 mg/mL

Frequency: single dose at baseline
Control: observation

Outcomes

Length of follow‐up: 6 months
Primary outcome, as defined in study reports: time from baseline to complete resolution of neurosensory retinal detachment during follow‐up
Secondary outcomes, as defined in study reports: serial changes in logMAR BCVA, OCT CFT, FA, and ICGA and the systemic and ocular complications during the study
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 2, 3, 4, 5, 6 months

Notes

Full study name: Intravitreal ranibizumab for acute central serous chorioretinopathy
Type of study: published full‐text
Funding sources: 2012 Research Grant from Kangwon National University
Disclosures of interest: NR

Trial registry: not registered
Study period: January 2010 to December 2011, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

"Patients were randomized into the IVRI [anti‐VEGF] group or the observation group at a ratio of 1: 1" p. 153

No details on how the random allocation generated

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

High risk

Masking not reported and treatments different (injection vs. no treatment)

Masking of outcome assessment (detection bias)

High risk

Masking not reported and treatments different (injection vs. no treatment)

Incomplete outcome data (attrition bias)
All outcomes

High risk

Not reported how many were randomized by group and loss to follow‐up by group. Final numbers analyzed identical between treatment and observation group (20/20)

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry not available for comparison

Other bias

Low risk

Funding from non‐profit and conflict of interest was not reported. "This study was supported by 2012 Research Grant from Kangwon"

Klatt 2011

Methods

Study design: parallel randomized controlled trial
Number randomized:

14 eyes of NR participants in micropulse laser group ("selective retina therapy")
16 eyes of NR participants in placebo group
Exclusions after randomization:

0 in micropulse laser group ("selective retina therapy")
0 in placebo group
Number analyzed:

14 eyes of number of participants NR in micropulse laser group ("selective retina therapy")
16 eyes of number of participants NR in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in micropulse laser group ("selective retina therapy")
0 in placebo group
How were missing data handled?: NR
Power calculation: power = 80% and sample size = 62 eyes

Participants

Country: Germany
Mean age (SD) (years):

43.8 (5.6) in total
42.8 (5.5) in micropulse laser group ("selective retina therapy")
44.7 (5.7) in placebo group
Gender (%):

26 men (87%) and 4 women (13%) in total
14 men (100%) and 0 women (0%) in micropulse laser group ("selective retina therapy")
12 men (75%) and 4 women (25%) in placebo group
Participants with acute CSC were included and defined as: acute symptomatic CSC and a documented disease progression of at least 3 months' duration
Inclusion criteria: minimum age 18 years; minimum history 3 months of reduced visual acuity; minimum BCVA of 20 ETDRS letters (20/200); presence of SRF on OCT; and presence of active angiographic leakage in FA

Exclusion criteria: other retinal diseases; glaucoma; cataract or other media opacities, which preclude color fundus photography and FA; previous PDT or continuous wave laser photocoagulation for CSC; systemic corticosteroid treatment, Cushing disease, renal diseases, pregnancy, and breastfeeding
Equivalence of baseline characteristics: NR

Interventions

Intervention: micropulse laser ("selective retina therapy")

Q‐switched neodymium‐doped yttrium lithium fluoride (Nd:YLF) laser

wavelength: 527 nm

spot diameter; 200 µm

pulse repetition rate: 100 Hz
Control: observation

Outcomes

Length of follow‐up: 3 months
Primary outcome, as defined in study reports: change of best corrected Early Treatment Diabetic Retinopathy Study visual acuity (BCVA); change in SRF as measured by OCT
Secondary outcomes, as defined in study reports: rate of complete absorption of SRF; presence of leakage in FA; systemic or ocular adverse effects
Adverse events reported: yes
Intervals at which outcomes assessed: 1 and 3 months

Notes

Full study name: Selective retina therapy for acute central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: "Johann Roider, Ralf Brinkmann and Reginald Birngruber hold patents on selective retina therapy. Carsten Klatt, Mark Saeger, Till Oppermann, Erk Porksen, Felix Treumer, Jost Hillenkamp and Elfriede Fritzer have no competing interests"

Trial registry: NCT00987077 (clinicaltrials.gov)
Study period: April 2007 to June 2008, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Low risk

"Sequentially numbered, opaque, sealed envelopes were prepared on the basis of the accomplished randomisation" p. 84

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

"At all visits, BCVA was assessed using ETDRS charts at 4 m distance. The investigator was blinded" p. 84

Masking for other outcomes not reported and visual acuity assessment may be affected by the fact that the patient knew which group they were in

Incomplete outcome data (attrition bias)
All outcomes

Low risk

"All patients kept their follow‐up appointment and were included in the analysis" p. 84

Selective reporting (reporting bias)

Low risk

All outcomes reported as stated in the trials registry entry (NCT00987077; clinicaltrials.gov)

Other bias

High risk

Source of monetary support was not reported and conflict of interest was declared: "Johann Roider, Ralf Brinkmann and Reginald Birngruber hold patents on selective retina therapy. Carsten Klatt, Mark Saeger, Till Oppermann, Erk Porksen, Felix Treumer, Jost Hillenkamp and Elfriede Fritzer have no competing interests"

Leaver 1979

Methods

Study design: parallel randomized controlled trial
Number randomized:

NR eyes of 35 participants in argon laser group
NR eyes of 35 participants in placebo group
Exclusions after randomization: NR
Number analyzed:

NR eyes of 32 participants in argon laser group
NR eyes of 31 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

NR eyes of 3 participants in argon laser group
NR eyes of 4 participants in placebo group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: UK
Mean age (SD) (years):

40.1 (NR) in total
NR in argon laser group
NR in placebo group
Gender (%):

53 men (84%) and 10 women (16%) in total
NR in argon laser group
NR in placebo group
Participants with both acute or chronic CSC were enrolled

Inclusion criteria: corrected visual acuity ≥ 6/12; retina detached at macula; RPE defects < 1 disc diameter; no symptomatic improvement since onset; no subretinal exudates present; no cystic retinal edema present; no associated ocular disease (e.g. drusen, congenital pit of the disc, generalized RPE dystrophy, etc.); consent to participate in the study after explanation of aims and methods
Equivalence of baseline characteristics: NR

Interventions

Intervention: argon laser (direct)
Control: observation

Outcomes

Length of follow‐up: 12.1 years
Primary and secondary outcomes not differentiated
Outcomes: time to recovery; visual acuities; hue discrimination
Adverse events reported: no
Intervals at which outcomes assessed: "weekly intervals for 4 weeks and then at monthly intervals until symptoms improved, the retina flattened, and there was no identifiable leakage on fluoresce in fundus angiography (FFA). Thereafter examinations were carried out at 3‐ and 6‐monthly intervals. Longest follow‐up 12 years"

Notes

Full study name: Argon laser photocoagulation in the treatment of central serous retinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No details on how the random allocation generated: "randomised cards from sealed envelopes" p. 675

Allocation concealment (selection bias)

Unclear risk

"...randomised cards from sealed envelopes" (p. 675) but not enough information on how sealed envelopes were prepared e.g. sequentially number? opaque?

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

Groups different and no mention of masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

7/70 (10%) missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Lim 2010

Methods

Study design: parallel randomized controlled trial
Number randomized:

32 eyes of number of participants NR in total

By group NR
Exclusions after randomization: NR
Number analyzed:

12 eyes of 12 participants in anti‐VEGF group
12 eyes of 12 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

8 eyes of number of participants NR in total; by group NR
How were missing data handled?: NR
Power calculation: NR

Participants

Country: South Korea
Mean age (SD) (years):

43.2 (9.0) in total
45.6 (10.4) in anti‐VEGF group
40.7 (7.0) in placebo group
Gender (%):

20 men (83%) and 4 women (17%) in total
9 men (75%) and 3 women (25%) in anti‐VEGF group
11 men (92%) and 1 women (8%) in placebo group
Participants with acute CSC were included and defined as: "patients with symptomatic CSC of less than a 3‐month duration"
Inclusion criteria: diagnosis of CSC was established by the presence of serous macular detachment on fundus examination and dilated choroidal vasculature and hyperpermeability on ICGA

Exclusion criteria: participants who had received any previous treatment, including PDT or focal thermal laser photocoagulation for CSC, or who had evidence of CNV, polypoidal choriovasculopathy, or other maculopathy on clinical examination, FA, or ICGA
Equivalence of baseline characteristics: NR

Interventions

Intervention: anti‐VEGF (bevacizumab)

Dose: 1.25 mg/0.05 mL

Frequency: single dose injected < 1 week after diagnosis

Control: observation

Outcomes

Length of follow‐up: 6 months
Primary outcome, as defined in study reports: time measured from baseline to complete absorption of SRF during follow‐up
Secondary outcomes, as defined in study reports: serial changes in the logMAR visual acuity and OCT central 1‐mm macular thickness
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 2, 3, 4, 5, and 6 months

Notes

Full study name: The effect of intravitreal bevacizumab in patients with acute central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: not registered
Study period: March 2008 to August 2008, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The randomization sequence was generated using a computerized randomization table" p. 156

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

Groups different and no mention of masking

Incomplete outcome data (attrition bias)
All outcomes

High risk

8/32 (25%) of participants not followed up and not reported which group they were in

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Low risk

Source of monetary support not reported and conflict of interest declared: "no potential conflict of interest relevant to this article was reported"

Ontiveros‐Orozco 2004

Methods

Study design: parallel randomized controlled trial
Number randomized:

16 participants were included in the study, but allocation not reported

NR eyes of NR participants in carbonic anhydrase inhibitor group
NR eyes of NR participants in placebo group
Exclusions after randomization: 3
Number analyzed:

Number of eyes NR of 7 participants in carbonic anhydrase inhibitor group
Number of eyes NR of 6 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up: NR
How were missing data handled?: NA
Power calculation: NR

Participants

Participants with acute CSC were included and define as: participants with "symptoms for less than 20 days, no previous treatment"

Country: Mexico
Mean age (SD) (years):

NR in total
NR in carbonic anhydrase inhibitors group
NR in placebo group
Gender (%):

9 men (69%) and 4 women (31%) in total
4 men (57%) and 3 women (43%) in carbonic anhydrase inhibitors group
5 men (83%) and 1 women (17%) in placebo group
Inclusion criteria: CSC idiopathic; fluorangiography showing hyperfluorescence associated with serous retinal pigment epithelial detachment; with 3 months of follow‐up after recovery and provide informed consent
Exclusion criteria: "any patients older than 50 years, patients that had any additional pre‐existing ocular pathology or systematic pathology. Any patients were eliminated that did not comply with their appointments, studies, or that had received any medications during their development"
Equivalence of baseline characteristics: NR

Interventions

Intervention: carbonic anhydrase inhibitors (brinzolamide)

Dose: 2%

Duration: twice daily

Control: placebo (polyvinyl alcohol)

Outcomes

Length of follow‐up: 6 months
Primary outcome, as defined in study reports: time to clinical recovery
Secondary outcomes, as defined in study reports: "complications: RPE atrophy, recurrence, persistence of subretinal fluid and appearance of neovascular membranes. Each complication received a value according to the severity (from 0 for the absence of complications to 4 for the presence of neovascular membranes)"
Adverse events reported: reported no adverse effects
Intervals at which outcomes assessed: weekly for the first month, then monthly for 3 months, and 6 months

Notes

Full study name: Brinzolamide for topical treatment coroidorretinopatía idiopathic central serous
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: June 2002 to October 2003, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Low risk

The labeling and drug control was done by third person not related with the study p. 134

Masking of participants and personnel (performance bias)

Unclear risk

Similar groups (both groups' treatment were eye drops), but no information on masking

Masking of outcome assessment (detection bias)

Unclear risk

Similar groups (both groups' treatment were eye drops), but no information on masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Pitcher 2015

Methods

Study design: parallel randomized controlled trial
Number randomized:

6 eyes of 6 participants in 6‐dose group
6 eyes of 6 participants in 4‐dose group
Exclusions after randomization:

0 in 6‐dose group
0 in 4‐dose group
Number analyzed:

6 eyes of 6 participants in 6‐dose group
6 eyes of 6 participants in 4‐dose group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in 6‐dose group
0 in 4‐dose group
How were missing data handled?: NA
Power calculation: NR

Participants

Country: USA
Mean age (SD) (years):

NR in total
53.50 (9.61) in 6‐dose group
53.83 (12.80) in 4‐dose group
Gender (%): all participants were men

Participants with chronic CSC were included as defined as: "persistent CSCR [CSC] demonstrated by subfoveal fluid (SFF) on optical coherence tomography (OCT) for greater than 3 months"
Inclusion criteria: age ≥ 18 years; ability to provide informed consent; persistent CSC demonstrated by SFF on OCT for > 3 months; active leakage on FA at the time of enrolment; evidence of hyperpermeability and abnormal dilation of choroidal vasculature on ICGA; BCVA between 20/25 and 20/320. Only 1 eye for each participant was included in participants with bilateral CSC

Exclusion criteria: concurrent progressive retinal or substantial ocular disease in the study eye; prior treatment for CSC in the study eye (anti‐VEGF, PDT, or laser) within 3 months prior to enrolment; presence of CNV or polypoidal choroidal vasculopathy on enrolment imaging; history of intraocular surgery except uncomplicated cataract surgery > 3 months prior to enrolment; prior treatment with systemic anti‐VEGF agents or steroid agents within the preceding 12 months; uncontrolled glaucoma; history of cerebrovascular accident or myocardial infarction; pregnancy
Equivalence of baseline characteristics: NR

Interventions

Intervention: 6‐dose group (aflibercept)

Dose: 2.0 mg/0.05 mL

Duration: single dose at baseline, 1, 2, 3, 4, and 5 weeks

Control: 4‐dose group (aflibercept)

Dose: 2.0 mg/0.05 mL

Duration: single dose at baseline, 1, 2, and 4 weeks

Outcomes

Length of follow‐up: 6 months
Primary and secondary outcomes not differentiated

Outcomes listed as: occurrence of ocular or systemic adverse events; mean change from baseline in ETDRS letter score; percentage of eyes with 20/40 or better vision; percentage of eyes with ≥ 15‐letter gain from baseline; percentage of eyes with < 15‐letter loss from baseline; mean change in CMT; mean change in SFF manually measured by a masked observer; percentage of eyes with complete resolution of macular fluid on OCT; mean change in subfoveal choroidal thickness as measured via enhanced depth imaging; and percentage of eyes with absence of leakage on FA
Adverse events reported: yes
Intervals at which outcomes assessed: 6 months

Notes

Full study name: A prospective pilot study of intravitreal aflibercept for the treatment of chronic central serous chorioretinopathy: the CONTAIN study
Type of study: published full‐text
Funding sources: Regeneron Pharmaceuticals
Disclosures of interest: "none"

Trial registry: NCT01710332 (clinicaltrials.gov)

Study period: November 2012 to May 2013, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

"Patients were randomised to two groups" p. 849

Did not clear describe method of randomization

Allocation concealment (selection bias)

Unclear risk

Did not describe clearly how the sequence generation was assigned/stored

Masking of participants and personnel (performance bias)

Unclear risk

Masking not reported

Masking of outcome assessment (detection bias)

Unclear risk

SFF height was determined by a masked observer using the digital caliper function to measure distance from the hyper‐reflective RPE to the photoreceptor outer segments on a b‐scan through the foveal center point. Choroidal thickness was determined by a masked observer using the digital caliper to measure distance from the inner border of the choroido‐scleral interface to the hyper‐reflective RPE

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

High risk

Did not clearly define the primary and secondary outcomes in the published full‐text, while the trial registry had primary and secondary outcomes were clearly defined. Reported 5 additional outcomes not defined in the trial registry: "mean change in CMT; mean change in SFF manually measured by a masked observer; percentage of eyes with complete resolution of macular fluid on OCT; mean change in subfoveal choroidal thickness as measured via enhanced depth imaging; and percentage of eyes with absence of leakage on FA

Other bias

High risk

Industry funding
Rahbani‐Nobar 2011

Methods

Study design: parallel randomized controlled trial
Number randomized:

NR eyes of 25 participants in Helicobacter pylori group
NR eyes of 25 participants in placebo group
Exclusions after randomization:

0 in H. pylori group
0 in placebo group
Number analyzed:

NR eyes of 25 participants in H. pylori group
NR eyes of 25 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in H. pylori group
0 in placebo group
How were missing data handled?: NA
Power calculation: NR

Participants

Participants with acute CSC were included but definition not given

Country: Iran
Mean age (SD) (years):

NR in total
32.54 (4.57) in H. pylori group
34.24 (4.78) in placebo group
Gender (%):

41 men (82%) and 9 women (18%) in total
21 men (84%) and 4 women (16%) in H. pylori group
20 men (80%) and 5 women (20%) in placebo group
Inclusion criteria: to accept participation in the study by signing an informed consent; not having been treated with antibiotics, a proton pomp inhibitor, corticosteroids, or sympathomimetic drugs for 3 months before the study; no history of previous ocular surgery
Equivalence of baseline characteristics: NR

Interventions

Intervention:H. pylori

Drugs: metronidazole and amoxicillin

Dose: 500 mg

Frequency: 3 times daily

Duration: 2 weeks

Drug: omeprazole

Dose: NR

Frequency: once daily

Duration: 6 weeks

Control: observation

Outcomes

Length of follow‐up: 16 weeks
Primary and secondary outcomes not differentiated

Outcomes: average neuroretinal and/or pigment epithelial detachment; number of cases that reached zero subretinal fluid value; subretinal fluid level; subretinal fluid reabsorption time; mean visual acuity

Adverse events reported: yes
Intervals at which outcomes assessed: 2, 4, 6, 8, 12, and 16 weeks

Notes

Full study name: The effect of Helicobacter pylori treatment on remission of idiopathic central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: NCT00817245 (clinicaltrials.gov)

Study period: February 2008 to January 2010, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The patients were divided in two groups using random allocation software" p. 100

Allocation concealment (selection bias)

Unclear risk

"The patients were divided in two groups using random allocation software" p. 100, but no information specifically on allocation concealment

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

Groups different and no mention of masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Low risk

Outcomes on clinical trials registry entry (NCT00817245) were reported in the full text

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Ratanasukon 2012

Methods

Study design: parallel randomized controlled trial
Number randomized:

29 eyes of 29 participants in antioxidant group
29 eyes of 29 participants in placebo group
Exclusions after randomization: NR
Number analyzed:

26 eyes of 26 participants in antioxidant group
25 eyes of 25 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

3 eyes of 3 participants in antioxidant group
4 eyes of 4 participants in placebo group
How were missing data handled?: NR
Power calculation: power = 80% and sample size = 58 participants in total (29 participant in each group)

Participants

Country: Thailand
Mean age (SD) (years):

40.4 (NR) in total
41.28 (5.07) in antioxidant group
39.48 (6.95) in placebo group
Gender (%):

48 men (83%) and 10 women (17%) in total
23 men (79%) and 6 women (21%) in antioxidant group
25 men (86%) and 4 women (14%) in placebo group
Participants with acute CSC were included and defined as: "onset within 6 weeks"
Inclusion criteria: people with acute CSC (within 6 weeks of onset), aged 30‐50 years, new or recurrent attack (symptom‐free ≥ 6 months), FA‐confirmed diagnosis with inkblot or smoke‐stack leakage, OCT by Status OCT showing definite SRF and the people's ability for proper follow‐up
Exclusion criteria: chronic CSC (> 6 weeks), multiple attacks (> 2 times), large pigment epithelial detachment (> 1 disc diameter), multiple pigment epithelial detachment or diffuse retinal pigment epitheliopathy, younger or older ages, follow‐up time < 3 months, complicated CSC such as secondary CNV detected from FA, pregnancy, steroid use and people with contraindication from high‐dose antioxidant therapy such as heavy smokers, and people with lung cancer, thyrotoxicosis, renal stones and anemia (hematocrit < 30%)
Equivalence of baseline characteristics: NR

Interventions

Intervention: antioxidant (Icaps: vitamin A (6600 IU); vitamin C (400 mg), vitamin E (150 IU); riboflavin (10 mg); zinc (60 mg); copper (4 mg); selenium (40 mg); manganese (4 mg) and lutein/zeaxanthin (4000 μg))
Control: placebo

Outcomes

Length of follow‐up: 3 months planned but 12 months reported (with high attrition)
Primary outcome, as defined in study reports: change in visual acuity; change in CMT recorded by OCT during every visit
Secondary outcomes, as defined in study reports: number of participants with SRF at each follow‐up time, the number of participants who showed FA leakage at the end of the 3rd month and participants who received additional treatments in each group
Adverse events reported: yes
Intervals at which outcomes assessed: 1, 2, 3, 6, and 12 months

Notes

Full study name: High‐dose antioxidants for central serous chorioretinopathy; the randomized placebo‐controlled study
Type of study: published full‐text
Funding sources: "study and placebo drugs were contributed by Alcon Laboratories (Thailand)"
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: NCT00963131 (clinicaltrials.gov)
Study period: December 2004 to December 2008, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The patients were randomly assigned to high‐dose antioxidant or placebo drugs. The randomization was computer generated with a 1:1 ratio, block lengths of 4 and random numbers were coded to all bottles. Moreover, the codes were in envelops until the end of the study" p. 2

Allocation concealment (selection bias)

High risk

"The corresponding author generated the allocation sequence, enrolled and assigned the patients to any additional treatments when needed" p. 2

Masking of participants and personnel (performance bias)

Low risk

"The patients were randomly assigned to high‐dose antioxidant or placebo drugs. The randomization was computer generated with a 1:1 ratio, block lengths of 4 and random numbers were coded to all bottles. Moreover, the codes were in envelops until the end of the study" p. 2

Masking of outcome assessment (detection bias)

Low risk

"The patients were randomly assigned to high‐dose antioxidant or placebo drugs. The randomization was computer generated with a 1:1 ratio, block lengths of 4 and random numbers were coded to all bottles. Moreover, the codes were in envelops until the end of the study" p. 2

Incomplete outcome data (attrition bias)
All outcomes

High risk

3/29 lost to follow‐up at 3 months in intervention group and 4/29 lost to follow‐up in control group but at 12 months only 7 participants seen in each group. So low risk of bias for 3 months and high risk of bias for 12 months outcomes

Selective reporting (reporting bias)

Low risk

Trial registry entry was available for comparison, and all outcomes were reported as per the trial registry

Other bias

Unclear risk

"Study and placebo drugs were contributed by Alcon Laboratories (Thailand)" but authors reported that none of the authors had any financial relationship

Robertson 1983

Methods

Study design: parallel randomized controlled trial
Number randomized:

15 eyes of 15 participants in argon (direct) laser group
15 eyes of 15 participants in sham laser group
7 eyes of 7 participants in argon (direct) laser group
5 eyes of 5 participants in argon (indirect) laser group
Exclusions after randomization: NR
Number analyzed:

15 eyes of 15 participants in argon (direct) laser group
15 eyes of 15 participants in sham laser group
7 eyes of 7 participants in argon (direct) laser group
5 eyes of 5 participants in argon (indirect) laser group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up: NR
How were missing data handled?: NR
Power calculation: NR
Unusual study design: eyes were divided into 2 groups depending on the site of leakage (determined by FA)

"We assigned eyes in which the leakage site was in the papillomacular bundle or within 500 μm of the capillary‐free zone of the macula to Group A"
"We assigned eyes in which the leakage site was outside the papillomacular bundle and more than 500 μm from the capillary‐free zone to Group B"

Participants

Country: US
Mean age (SD) (years):

NR in total
39.7 (NR) in argon (direct) laser group
NR in sham laser group
41.3 (NR) in argon (direct) laser group
44.8 (NR) in argon (indirect) laser group
Gender (%):

29 men (69%) and 13 women (31%) in total
10 men (67%) and 5 women (33%) in (direct) laser group
9 men (60%) and 6 women (40%) in sham laser group
5 men (71%) and 2 women (29%) in (direct) laser group
5 men (100%) and 0 women (0%) in (indirect) laser group
Participants with acute CSC were included and defined as: "central serous chorioretinopathy of recent onset" p. 458
Inclusion criteria: no evidence of previous ocular surgery, trauma, photocoagulation, cloudy media, vitreous inflammation, retinal vessel occlusion, hypertensive or diabetic retinopathy, vitreoretinal traction, congenital optic pits, mass lesion, or any other unusual retinal or choroidal abnormality
Equivalence of baseline characteristics: NR

Interventions

Group A intervention: argon laser (indirect laser photocoagulation)
Group A control: sham laser
Group B intervention: argon laser (direct laser photocoagulation)
Group B control: argon laser (indirect laser photocoagulation

Outcomes

Length of follow‐up: examined at 6 months recurrences reported to 18 months
Primary and secondary outcomes not differentiated
Outcomes: resolution of CSC as determined by 2 observers by following criteria: subretinal fluid absent on biomicroscopic exam and stereoscopic FA showed no active leakage; visual acuity measured by Sloan chart; visual fields
Adverse events reported: no
Intervals at which outcomes assessed: 2 weeks, 6 months, 18 months

Notes

Full study name: Direct, indirect, and sham laser photocoagulation in the management of central serous chorioretinopathy
Type of study: published full‐text
Funding sources: Grant EY0 1709 from the National Eye Institute and by the Mayo Foundation
Disclosures of interest: NR

Trial registry: not registered
Study period: May 1977 to January 1981, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No details on how the random allocation generated: "After the patient was positioned at the laser, a sealed envelope containing the randomized treatment assignment was opened. The assignments, worked out and kept by the statistician, directed the physician (D.M.R. in all cases) to administer direct, indirect, or sham laser photocoagulation" p. 459

Allocation concealment (selection bias)

Low risk

"After the patient was positioned at the laser, a sealed envelope containing the randomized treatment assignment was opened. The assignments, worked out and kept by the statistician, directed the physician (D.M.R. in all cases) to administer direct, indirect, or sham laser photocoagulation." p. 459

Masking of participants and personnel (performance bias)

Low risk

"The subject did not learn which of the three forms of treatment he or she had received until the study ended six months later" pp. 459‐460

Masking of outcome assessment (detection bias)

Unclear risk

Similar groups (both groups' treatment were laser), but no information on masking of outcome assessor

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Not reported

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Funded by government sources but conflicts of interest were not reported
Roisman 2013

Methods

Study design: parallel randomized controlled trial
Number randomized:

10 eyes of 10 participants in micropulse diode laser group
5 eyes of 5 participants in placebo group
Exclusions after randomization:

0 in micropulse diode laser group
0 in placebo group
Number analyzed:

10 eyes of 10 participants in micropulse diode laser group
5 eyes of 5 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in micropulse diode laser group
0 in placebo group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: Brazil
Mean age (SD) (years):

NR in total
39.5 (7.7) in micropulse diode laser group
44.2 (5.8) in placebo group
Gender (%):

10 men (67%) and 5 women (33%) in total
7 men (70%) and 3 women (30%) in micropulse diode laser group
3 men (60%) and 2 women (40%) in placebo group
Participants with chronic CSC were included and defined as: "CSC lasting more than 6 months were enrolled"
Inclusion criteria: NR
Equivalence of baseline characteristics: NR

Interventions

Intervention: micropulse diode laser

Wavelength: 810 nm

FastPulse laser; Opto, Brazil
Control: sham laser

Outcomes

Length of follow‐up: 12 months
Primary outcome, as defined in study reports: change in visual acuity after 3 months
Secondary outcomes, as defined in study reports: change in CMT after 3 months
Adverse events reported: no
Intervals at which outcomes assessed: 1, 3, 6, and 12 months

Notes

Full study name: Micropulse diode laser treatment for chronic central serous chorioretinopathy: a randomized pilot trial
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: NCT01327170 (clinicaltrials.gov)
Study period: NR

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The 15 patients were randomized 2:1 through double‐masked random draw into two groups" p. 466

Allocation concealment (selection bias)

Low risk

"The 15 patients were randomized 2:1 through double‐masked random draw into two groups" p. 466

Masking of participants and personnel (performance bias)

Low risk

Double‐masked with placebo group

Masking of outcome assessment (detection bias)

Low risk

Double‐masked with placebo group

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Low risk

All primary and secondary outcomes stated in the trial registry were reported

Other bias

Low risk

Source of monetary funding not reported but the conflict of interest declared: "the authors have no financial or proprietary interest in the materials presented herein"

Sawa 2014

Methods

Study design: parallel randomized controlled trial
Number randomized:

Total number randomized was 44

Unclear number in each group
Exclusions after randomization: 5 people excluded after randomization but not reported to which groups they belonged
Number analyzed:

NR eyes of 20 participants in antioxidant group
NR eyes of 19 participants in placebo group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up: NR
How were missing data handled?: NR
Power calculation: NR

Participants

The type of CSC was not specified

Country: Japan
Mean age (SD) (years):

49 (10) in total
51.2 (9) in antioxidant group
46.6 (8.3) in placebo group
Gender (%):

35 men (90%) and 4 women (10%) in total
19 men (95%) and 1 women (5%) in antioxidant group
16 men (84%) and 3 women (16%) in placebo group
Inclusion criteria: previous regular intake of lutein or zeaxanthin, or both; corticosteroid treatment; disturbance of ocular media; other retinal disorders such as age‐related macular degeneration, polypoidal choroidal vasculopathy, retinal vein occlusion, or diabetic retinopathy
Equivalence of baseline characteristics: NR

Interventions

Intervention: antioxidant (lutein)

Dose: 20 mg/day
Control: placebo

Outcomes

Length of follow‐up: 4 months
Primary outcome, as defined in study reports: macular pigment optical density and plasma lutein concentration
Secondary outcomes, as defined in study reports: NR
Adverse events reported: no
Intervals at which outcomes assessed: 1 and 4 months

Notes

Full study name: Effects of a lutein supplement on the plasma lutein concentration and macular pigment in patients with central serous chorioretinopathy
Type of study: published full‐text
Funding sources: Santen Pharmaceutical Co., Ltd
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: not registered
Study period: March 2011 to June 2012, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Low risk

"The study was a randomized, double‐masked, placebo‐controlled trial" p. 5239

Masking of participants and personnel (performance bias)

Low risk

"The study was a randomized, double‐masked, placebo‐controlled trial" p. 5239

Masking of outcome assessment (detection bias)

Low risk

"The study was a randomized, double‐masked, placebo‐controlled trial" p. 5239

Incomplete outcome data (attrition bias)
All outcomes

High risk

5 people excluded after randomization but not reported to which groups they belonged

Selective reporting (reporting bias)

High risk

BCVA measured but not reported. Only reported resolution of CSC for the intervention (lutein) group

Other bias

High risk

Funded by manufacturer of the supplement. Authors reported not having any conflict of interest

Semeraro 2012

Methods

Study design: parallel randomized controlled trial
Number randomized:

12 eyes of 12 participants in anti‐VEGF group
10 eyes of 10 participants in PDT group
Exclusions after randomization:

12 eyes of 12 participants in anti‐VEGF group
10 eyes of 10 participants in PDT group
Number analyzed:

12 eyes of 12 participants in anti‐VEGF group
10 eyes of 10 participants in PDT group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in anti‐VEGF group
0 in PDT group
How were missing data handled?: NR
Power calculation: NR

Participants

Participants with chronic CSC were included and defined as: "...either persistence of subretinal fluid detected on optical coherence tomography (OCT) for at least 3 months after diagnosis or more than 3 recurrences in at least 3 months with gravitational RPE atrophy" and "The inclusion criteria consisted of presence of CSC with chronic foveal detachment of the neuroepithelium (C3 months) and no previous treatment for CSC"

Country: Italy
Mean age (SD) (years):

NR in total
35.2 (6) in anti‐VEGF group
36 (8) in PDT group
Gender (%):

13 men (59%) and 9 women (41%) in total
7 men (58%) and 5 women (42%) in anti‐VEGF group
6 men (60%) and 4 women (40%) in PDT group
Inclusion criteria: presence of CSC with chronic foveal detachment of the neuroepithelium (≥ 3 months) and no previous treatment of CSC
Exclusion criteria: ages > 50 years; chronic systemic disease; pregnancy; any uncontrolled ocular disease; and presence of occult or minimally classic choroidal neovascular lesions, scarring, or atrophy within the lesion
Equivalence of baseline characteristics: NR

Interventions

Intervention: anti‐VEGF (bevacizumab)

Dose: 1.25 mg

Duration: single dose at baseline and then as needed after 4 weeks
Control: low fluence PDT

Light dose: 25 J/cm2

Verteporfin concentration: NR

Outcomes

Length of follow‐up: 9 months
Primary and secondary outcomes not differentiated
Outcomes: change in macular thickness; the number of eyes with recurrence; stabilization of the lesions; the number of retreatments
Adverse events reported: no
Intervals at which outcomes assessed: 9 months

Notes

Full study name: Intravitreal bevacizumab versus low‐fluence photodynamic therapy for treatment of chronic central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: February 2009 to April 2010, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"Enrolled patients were randomly assigned to group 1 or group 2 by random block permutation in accordance with a computer‐generated randomization list" p. 609

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

High risk

Groups different and no mention of masking

Masking of outcome assessment (detection bias)

High risk

Groups different and no mention of masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Shang 1999

Methods

Study design: parallel randomized controlled trial
Number randomized:

NR eyes of 30 participants in yellow laser group
NR eyes of 30 participants in red laser group

NR eyes of 30 participants in green laser group
Exclusions after randomization:

0 in yellow group
0 in red group

0 in green group

Number analyzed:

NR eyes of 30 participants in yellow group
NR eyes of 30 participants in red group

NR eyes of 30 participants in green group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in yellow group
0 in red group

0 in green group
How were missing data handled?: NR
Power calculation: NR

Participants

The type of CSC was not specified

Country: China
Mean age (SD) (years):

40.0 (6.3) in total

43.7 (7.6) in yellow group
39.9 (7.0) in red group

39.5 (5.0) in green group
Gender (%):

79 men (89%) and 10 women (11%) in total

NR in yellow group
NR in red group

NR in green group

Inclusion criteria:

people with CSC validated by eye exam, Amsler chart examine and FFA;
duration of the disease > 8 weeks;
corrected visual acuity ≤ 0.8;
distance between fundus fluorescein leakage point showed by FFA and central fovea of macula > 250 µm
Exclusion criteria: NR
Equivalence of baseline characteristics: NR

Interventions

Intervention 1: yellow

Intervention 2: red

Control: green

Outcomes

Length of follow‐up: 12 months
Primary and secondary outcomes not differentiated
Outcomes: visual acuity; light sensitivity; recurrent rate; disease course; photocoagulation energy; photocoagulation spot expansion
Adverse events reported: yes, made mention of protrusion, proliferation/diffusion, RPE complications
Intervals at which outcomes assessed: 12 months

Notes

Full study name: Wavelength selection in management of central serous chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: NR

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Not reported

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

Unclear risk

No mention of masking

Masking of outcome assessment (detection bias)

Unclear risk

No mention of masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Verma 2004

Methods

Study design: parallel randomized controlled trial
Number randomized:

NR eyes of 15 participants in micropulse diode laser group
NR eyes of 15 participants in argon laser group
Exclusions after randomization:

0 in micropulse diode laser group
0 in argon laser group
Number analyzed:

NR eyes of 15 participants in micropulse diode laser group
NR eyes of 15 participants in argon laser group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in micropulse diode laser group
0 in argon laser group
How were missing data handled?: NR
Power calculation: NR

Participants

Country: India
Mean age (SD) (years):

NR in total
34.06 (2.54) in micropulse diode laser group
34.66 (3.23) in argon laser group
Gender (%):

25 men (83%) and 5 women (17%) in total
12 men (80%) and 3 women (20%) in micropulse diode laser group
13 men (87%) and 2 women (13%) in argon laser group
The type of CSC was not specified
Inclusion criteria: ages < 50 years; type I central serous retinopathy with a single leak on FA that was at least 300 μm away from fovea; presence of an indication for laser treatment (recurrence, occupational, history of poor visual outcome in fellow eye); no history of any treatment in the past
Exclusion Criteria: participants with multiple leak central serous retinopathy; type 2 or type 3 central serous retinopathy or leak at papillomacular bundle or leak within 300 μm from the foveal center; people with ocular pathology such as CNV, choroidal inflammatory, or neoplastic disorder or a congenital optic nerve pit
Equivalence of baseline characteristics: NR

Interventions

Intervention: micropulse diode laser

Wavelength: 810 nm
Control: argon laser (NR)

Wavelength: 514 nm

Outcomes

Length of follow‐up: 12 weeks
Primary and secondary outcomes not differentiated
Outcomes: mean BCVA; mean contrast sensitivity
Adverse events reported: no
Intervals at which outcomes assessed: 4, 8, and 12 weeks

Notes

Full study name: Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: a pilot, randomized controlled trial ISRCTN84128484
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: ISRCTN84128484 (ICTRP)
Study period: January 1998 to June 2000, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"They were randomly assigned into 2 groups according to the statistical random table using sequence generation" p. 2

Allocation concealment (selection bias)

Unclear risk

"The allocation of patients into 2 groups was done by a person who was not involved in the study and the sequence was concealed until interventions were assigned to prevent bias" p. 2

Masking of participants and personnel (performance bias)

Unclear risk

Similar groups but no information on masking

Masking of outcome assessment (detection bias)

Unclear risk

Similar groups but no information on masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Low risk

Source of monetary support not reported and conflict of interest declared: "the author(s) declare that they have no competing interests"

Zhang 2012

Methods

Study design: parallel randomized controlled trial
Number randomized:

30 eyes of 30 participants in 30% PDT group
30 eyes of 30 participants in 50% PDT group

30 eyes of 30 participants in PDT group
Exclusions after randomization:

0 in 30% PDT group

0 in 50% PDT group

0 in PDT group
Number analyzed:

30 eyes of 30 participants in 30% PDT group

30 eyes of 30 participants in 50% PDT group

30 eyes of 30 participants in PDT group

Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

0 in 30% PDT group

0 in 50% PDT group

0 in PDT group
How were missing data handled?: NR
Power calculation: NR

Participants

The type of CSC was not specified

Country: China
Mean age (SD) (years):

NR in total

33.8 (5.5) in 30% PDT group
34.2 (5.2) in 50% PDT group

32.0 (4.1) in PDT group

Gender (%):

25 men (83%) and 5 women (17%) in total
8 men (27%) and 22 women (73%) in 30% PDT group
11 men (37%) and 19 women (63%) in 50% PDT group

9 men (30%) and 21 women (70%) in PDT group
Inclusion criteria:
aged < 45 years with conscious visual distortion of imagery, darkened vision or changes of smaller imagery vision;
anterior segments do not have anything in particular or abnormal. Fundus exam should show macula regions or macula peripheral region gray spots with irregular formation or circular type infection, arching or ring‐shaped hemorrhage, including various degrees of retinal edema;
through FFA exam, low fluorescent shows in the early exudative lesion focus, hemorrhage spots always cover the fluorescein, but exudative lesion focus and mild bleeding spot could show CNV with typical petal shaped or trochoid shaped high fluorescent. As the time of radiography gets longer, fluorescein leakage could be observed. It is splinter high fluorescent, the scale and scope is similar to the gray exudative lesion focus;
excluding external injury related, myopia related, or other established causes of non‐age‐related macular degeneration CNV;
people who have not received laser photocoagulation, intraocular injections, or invasive surgical ocular treatments
Exclusion criteria:

history of penicillin allergy or systemic illnesses or issues with fluorescence or other systems of sexually transmitted disease that could cause intolerance of FFA treatment and PDT treatment;
serious corneal illness, cataracts, blood volume, light opacity interfering mediums that can disturb the treatment plan and examination plan of the study;
corneal endothelial cell scarring, shows FA has not created leakage;
poor participant compliance with those who cannot complete follow‐up times
Equivalence of baseline characteristics: NR

Interventions

Intervention: 30% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 2 mg/m2

Intervention: 50% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 3 mg/m2

Control: PDT

Light dose: 50 J/cm2

Verteporfin concentration: 6 mg/m2

Outcomes

Length of follow‐up: 12 months
Primary and secondary outcomes not differentiated
Outcomes: BCVA value change; number of eyes show CNV change; CFT value change; number of treatments; recurrence of CSC

Adverse events reported: no
Intervals at which outcomes assessed: 3, 6, and 12 months, but not all participants had 12 month

Notes

Full study name: Different doses of verteporfin photodynamic therapy for central exudative chorioretinopathy
Type of study: published full‐text
Funding sources: NR
Disclosures of interest: NR

Trial registry: not registered
Study period: January 2006 to December 2009, as reported in the full‐text article

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomization sequence specified and outlined in methods. Low risk of random sequence generation. The study used a number sequence table to assign proper randomization for groups. They used a verified and structured numbering sequence of 1‐90 that was aligned for row and column and considered from smallest value to largest. They then randomized and recorded each randomly generated assignment figure

Allocation concealment (selection bias)

Unclear risk

Not reported

Masking of participants and personnel (performance bias)

Unclear risk

Similar groups but no information on masking

Masking of outcome assessment (detection bias)

Unclear risk

Similar groups but no information on masking

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No missing data

Selective reporting (reporting bias)

Unclear risk

Study protocol and trial registry entry not available for comparison

Other bias

Unclear risk

Conflict of interest and source of funding not reported
Zhao 2015

Methods

Study design: parallel randomized controlled trial
Number randomized:

65 eyes of 65 participants in 30% PDT group

64 eyes of 64 participants in 50% PDT group
Exclusions after randomization:

0 in 30% PDT group

0 in 50% PDT group
Number analyzed:

61 eyes of 61 participants in 30% PDT group

56 eyes of 56 participants in 50% PDT group
Unit of analysis: participant, 1 eye per person
Losses to follow‐up:

4 eyes of 4 participants in 30% PDT group

9 eyes of 9 participants in 50% PDT group
How were missing data handled?: NR

Power calculation: power = 80% and sample size = 112 participants (56 participants in each group)

Participants

Country: China
Mean age (SD) (years):

NR in total
42.5 (5.6) in 30% PDT group

43.1 (5.3) in 50% PDT group
Gender (%):

87 men (74%) and 30 women (26%) in total
47 men (77%) and 14 women (23%) in 30% PDT group

40 men (71%) and 16 women (29%) in 50% PDT group
Participants with acute CSC were included and defined as: "symptoms occurred for the first time, as an episode duration of less than 6 months, or there was a medical record that could prove the presence of subretinal fluid (SRF) for less than 6 months if the patient was asymptomatic"
Inclusion criteria: symptoms occurred for the first time, as an episode duration of < 6 months, or there was a medical record that could prove the presence of SRF for < 6 months if the participant was asymptomatic; ages 18‐50 years; presence of SRF involving the macula and detected using OCT; active fluorescein leakage during FA and abnormal dilated choroidal vasculature detected using ICGA

Exclusion criteria: previous PDT, focal photocoagulation, intravitreal injections of anti‐VEGF, or ocular surgery; other macular abnormalities such as CNV or polypoidal choroidal vasculopathy; choroidopathy that may affect choroidal thickness; any retinal vascular disease that may have fluorescein leakage during FA; history of porphyria or photosensitivity; severe impaired kidney or liver function or unstable heart condition (or a combination of these); pregnancy; inability to obtain photographs or to perform FA or ICGA; use of steroid systemically or topically in the last 6 months
Equivalence of baseline characteristics: NR

Interventions

Intervention: 30% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 1.8 mg/m2
Control: 50% PDT

Light dose: 50 J/cm2

Verteporfin concentration: 3 mg/m2

Outcomes

Length of follow‐up: 12 months
Primary outcome, as defined in study reports: proportion of eyes with complete absorption of SRF; proportion of eyes with complete disappearance of fluorescein leakage at 6 and 12 months
Secondary outcomes, as defined in study reports: SRF recurrent rate; the fluorescein leakage recurrent rate at 12 months; mean BCVA; the retinal thickness of the foveal center; the maximum retinal thickness at each scheduled visit
Adverse events reported: yes
Intervals at which outcomes assessed: 2 weeks, 1, 3, 6, and 12 months

Notes

Full study name: A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one‐year results of a randomized clinical trial
Type of study: published full‐text
Funding sources: Capital Health Research and Development of Special Funding grant D101100050010026 and National Science and Technology Major Project grant 2011ZX09302‐007‐02
Disclosures of interest: reported explicitly none of the authors has any financial relationship

Trial registry: NCT01574430 (clinicaltrials.gov)
Study period: March 2011 to February 2012, as reported in the full‐text

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

"The randomization sequence was generated using a computerized randomization table" p. 334

Allocation concealment (selection bias)

Low risk

"All patients, examiners, investigators, and research assistants at the reading centers were masked to the treatment
allocation group" p. 334

Masking of participants and personnel (performance bias)

Low risk

"All patients, examiners, investigators, and research assistants at the reading centers were masked to the treatment allocation group" p. 334

Masking of outcome assessment (detection bias)

Low risk

"All patients, examiners, investigators, and research assistants at the reading centers were masked to the treatment allocation group" p. 334

Incomplete outcome data (attrition bias)
All outcomes

High risk

Level of lost to follow‐up was not the same in each group: 4/65 (6%) participants in 30% PDT group and 8/64 (13%) participants 50% PDT group

Selective reporting (reporting bias)

High risk

Primary outcome reported at clinicaltrials.gov (NCT01574430) was change from baseline in BCVA, but study primary outcome were OCT‐based improvement rate and FA‐based improvement rate at 6 and 12 months. BCVA was reported, but not defined as primary outcome

Other bias

Low risk

Reported no conflicts of interest and non‐industry funded

anti‐VEGF: anti‐vascular endothelial growth factor; BCVA: best‐corrected visual acuity; CFT: central foveal thickness; CMT: central macular thickness; CNV: choroidal neovascularization; CRT: central retinal thickness; CSC: central serous chorioretinopathy; FA: fluorescein angiography; FFA: fundus fluorescein angiography; ICGA: indocyanine green angiography; logMAR: logarithm of the minimal angle of resolution; NA: not applicable as no missing data or unclear if there is missing data; NR: not reported; OCT: optical coherence tomography; p: page; PDT: photodynamic therapy; RPE: retinal pigment epithelium; SD: standard deviation; SFF: subfoveal fluid; SRF: subretinal fluid; SLO‐ICGA: scanning laser indocyanine green angiography.

Characteristics of excluded studies [ordered by study ID]

Jump to:

Study

Reason for exclusion

Ainiwaer 2014

Wrong treatment arms and included traditional Chinese medicine; compared Argon laser to xueshuantong

Arevalo 2013

Not RCT

Aydin 2013

Not RCT

Beger 2012

Not RCT

Behnia 2013

Not RCT

Bi 2000

Not RCT

Boscia 2007

Not RCT

Bruha 1972

Not RCT

Cervera 2008

Not RCT

Chrapek 2015

Not RCT; randomization not clearly described

Demirel 2014

Not RCT

Di 2013

Wrong treatment arms and included traditional Chinese medicine; compared argon laser to traditional medication (vitamin C, E, inosine, rutin, xueshuantong, difrarel)

Earl 2014

Not RCT

Fang 2013

Wrong treatment arms and included traditional Chinese medicine; compared jolethin combined with argon laser (argon laser and oral jolethin, vitamin B1, inosine and venoruton tablets) to traditional medication (oral lecithin complex iodine, vitamin B1, inosine, venoruton tablets)

Feily 2009

Not RCT

Haas 2004

Not RCT

Heinrich 1974

Not RCT

Huang 2006

Wrong treatment arms and included traditional Chinese medicine; compared argon laser and iodine treatment to argon laser

Khosla 1997

Not RCT

Koss 2012

Not RCT

Kurimoto 1969

Not RCT

Lee 2011

Not RCT

Li 2010

Not RCT

Lim 2011

Not RCT

Liu 2009

Not RCT

Long 2011

Wrong treatment arms and included traditional Chinese medicine; compared krypton laser combined with danshen and inosine to krypton laser combined with anisodine

Lyons 1977

Not RCT

Mackowiakowa 1987

Not RCT

Miyashita 1971

Not RCT

NCT01256580

Wrong participants. RCT enrolled participants with age‐related macular degeneration

NCT01585441

This study was terminated early due to lack of enrollment

Novak 1987

Not RCT

Okamoto 2015

Not RCT

Ozdemir 2014

Not RCT

Peng 2010

Not RCT

Radian 1984

Not RCT

Sanchez‐Pacheco 2010

Not RCT

Takagi 1965

Not RCT

Tewari 1986

Not RCT; randomization not clearly described

Wang 2009a

Not RCT

Wang 2009b

Wrong treatment arms and included traditional Chinese medicine; compared therapeutic alliance group (injected subcutaneously compound anisodine injection 2 mL combined with joletion tablets taking) to joletion tablets group

Watzke 1974

Wrong participants

Watzke 1979

Wrong participants

Wu 2010

Wrong treatment arms and included traditional Chinese medicine; compared jolethin combined with argon laser to argon laser

Xu 2013

Not RCT

Xu 2014

Wrong treatment arms and included traditional Chinese medicine; compared anisodine injection to traditional medication (oral medication such as adenosine triphosphate, inosine, vitamin)

Ye 2013

Wrong treatment arms and included traditional Chinese medicine; compared argon laser combined with xueshuantong (laser combined with compound xueshuantong capsule) to argon laser

Zhang 2014

Not RCT

Zheng 2013

Wrong treatment arms and included traditional Chinese medicine; compared hyperbaric oxygen and iodized lecithin to hyperbaric oxygen

RCT: randomized controlled trial.

Characteristics of ongoing studies [ordered by study ID]

Jump to:

EUCTR2009‐017959‐98‐NL

Trial name or title

Early Treatment of Patients with Central Serous Retinopathy: a Randomized Controlled Trial ‐ CSR & PDT

Methods

Study design: parallel group RCT

Participants

Population age: adults, elderly

Gender: men and women

"Poor prognostic acute CSR [CSC]"

Interventions

NR PDT versus observation

Outcomes

Primary outcomes: visual acuity (BCVA ETDRS) at 1 year of follow‐up

Secondary outcomes: NR

Starting date

25 March 2010

Contact information

NR

Notes

Sponsor name: Rotterdam Eye Hospital

JPRN‐UMIN000005372

Trial name or title

Study on the Effects of Supplements Containing Lutein on Chronic Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: ≤ 40 years

Gender: male and female

Interventions

Intervention 1: multivitamins, minerals, and lutein

Control: placebo

Outcomes

Primary outcomes: rate of spontaneous resolution of CSC, changes in macular volume measured by OCT

Secondary outcomes: NR

BCVA

Starting date

NR

Contact information

Tsutomu Yasukawa

Nagoya City University Graduate School of Medical Sciences

Department of Ophthalmology and Visual Science

Notes

Sponsor name: Nagoya City University Graduate School of Medical Sciences

Source of funding: Santen Pharmaceutical Co., Ltd

NCT01019668

Trial name or title

Central Serous Chorioretinopathy Treated by Modified Photodynamic Therapy

Methods

Study design: parallel group RCT

Participants

Population age: 18‐75 years

Gender: men and women

Interventions

Intervention 1: verteporfin PDT, half‐dose

Intervention 2: verteporfin PDT, half‐fluence

Outcomes

Primary outcomes: effectiveness of both modification for the treatment of chronic CSC, fluorescent leakage as regards to BCVA OCT changes

Secondary outcomes: detrimental influence on choroidal perfusion, represented by the decrease of fluorescent intensity in ICGA

Starting date

November 2008

Contact information

Cheng‐Kuo Cheng, MD

Assistant Professor and Attending Physician of Ophthalmology

Shin‐Kong Wu Ho‐Su Memorial Hospital, School of Medicine, Fu‐Jen Catholic University

Notes

Sponsor name: Shin Kong Wu Ho‐Su Memorial Hospital

Source of funding: NR

NCT01552044

Trial name or title

Effect of Spironolactone in Treating Chronic Non‐Resolutive Central Serous Chorioretinitis

Methods

Study design: parallel group RCT

Participants

Population age: 18‐60 years

Gender: male and female

Interventions

Intervention 1: spironolactone 25 mg/day

Intervention 2: placebo

Outcomes

Primary outcomes: change in central macular thickness at 1 and 3 months, subretinal fluid decrease of 40 microns or more

Secondary outcomes: NR

Starting date

January 2012

Contact information

Francine Behar‐Cohen, MD, PhD

Hotel‐Dieu of Paris, France

Notes

Sponsor name: Institut National de la Santé Et de la Recherche Médicale, France

Source of funding: NR

NCT01630863

Trial name or title

The Safe Effective Light Dose of Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: 20‐70 years

Gender: men and women

Interventions

Intervention 1: 50% group (power of PDT is applied to the participants at 50% of the full energy based on TAP study)

Intervention 2: 40% group (power of PDT is applied to the participants at 40% of the full energy based on TAP study)

Intervention 3: 30% group (power of PDT is applied to the participants at 30% of the full energy based on TAP study)

Outcomes

Primary outcomes: change in BCVA at 1, 3, 6 and months

Secondary outcomes: change in central retinal thickness, success rate, recurrence rate, and complications at 1, 3, and 6 months

Starting date

June 2012

Contact information

Min Sagong

Yeungnam University College of Medicine

Daegu, Republic of Korea

Notes

Sponsor name: Yeungnam University College of Medicine

Source of funding: NR

NCT01797861

Trial name or title

Prospective Randomized Controlled Treatment Trial for Chronic Central Serous Chorioretinopathy (PLACE)

Methods

Study design: parallel group RCT

Participants

Population age: ≥ 18 years

Gender: men and women

Interventions

Intervention 1: half‐dose PDT

"In the PDT treatment arm, all patients will receive an intravenous drip through which half‐dose (3 mg/m2) verteporfin (Visudyne ®) is administered, with an infusion time of 10 minutes. At 15 minutes after the start of the infusion, PDT laser treatment is performed with standard 50 J/cm2 fluency, a wavelength of 689 nm, and a treatment duration of 83 seconds. If there still is subretinal fluid on OCT scan at Evaluation Visit 1 (6‐8 weeks after Treatment Visit 1 / the first treatment with half‐dose PDT), a second treatment with half‐dose PDT will be performed (Treatment Visit 2)"

Intervention 2: micropulse laser (ML) treatment

ML treatment with an 810 nm diode laser will be performed of the areas identified on mid‐phase ICG angiography. Multiple laser spots will be applied, covering the leakage area on mid‐phase ICG angiography. The area(s) that has to be treated is determined based on those hyperfluorescent area(s) on mid‐phase (approximately 10 minutes) ICG‐angiography that correspond to subretinal fluid accumulation in the macula on the OCT scan and hyperfluorescent "hot spots" on the mid‐phase (3 minutes) fluorescein angiogram. If there still is subretinal fluid on OCT scan at Evaluation Visit 1 (6‐8 weeks after Treatment Visit 1 / the first ML treatment), a second ML treatment will be performed (Treatment Visit 2)

Outcomes

Primary outcomes: absence of subretinal fluid on OCT scan

Secondary outcomes: BCVA

Starting date

December 2013

Contact information

Camiel JF Boon, MD PhD FEBO

Leiden University Medical Center, Netherlands

Myrte Breukink, MD

Radboud University Nijmegen Medical Centre, Institute of Ophthalmology, Netherlands

Notes

Sponsor name: Radboud University

Source of funding: NR

NCT01971190

Trial name or title

Efficacy and Safety of Intravitreal Aflibercept Injection for Subacute Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: 18‐60 years

Gender: men and women

Interventions

Intervention 1: aflibercept (Eylea) 2 mg intravitreal injection at baseline, 1 and 2 months

Control: sham injection at baseline, 1 and 2 months

Outcomes

Primary outcomes: change in central subfield thickness from baseline to 1, 2, 3, 4, 5, and 6 months

Secondary outcomes: percentage of eyes achieving complete resolution of subretinal fluid at 6 months, percentage of eyes achieving 20/20 vision at 6 months, number of aflibercept injections needed to achieve a complete resolution at 6 months, change in subfoveal choroidal thickness from baseline using EDI‐OCT at 1, 2, 3, 4, 5, and 6 months, adverse effects of intravitreal aflibercept (Eylea) injection up to 6 months

Starting date

October 2013

Contact information

Young Hee Yoon, MD

Asan Medical Center, Republic of Korea

Notes

Sponsor name: Asan Medical Center

Source of funding: NR

NCT01982383

Trial name or title

Study on the Use of Micropulse Laser to Treat Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: 30‐60 years

Gender: men and women

"New diagnosis of CSC"

Interventions

Intervention 1: micropulse laser treatment

"Patient's randomized to ML treatment would be treated with the following settings: 200 micron spot size, 0.2 second duration, 15% duty cycle, and 300 milliWatt power. Their eyes would be dilated prior to treatment with standard mydriatic medications, including Tropicamide and Phenylephrine"

Control: no treatment

"Patients randomized to this treatment arm, will not receive treatment for CSC. They will continue to be observed at month 1 and month 3. If any worsening of pathology is found during the follow‐up visits, the patient will be removed from the study and given appropriate standard of care by the attending"

Outcomes

Primary outcomes: resolution of fluid build‐up within 1 week to 3 months after the laser procedure is completed

Secondary outcomes: NR

Starting date

November 2012

Contact information

Khadijah Abdallah, MPH

George Washington University, District of Columbia, United States

Notes

Sponsor name: George Washington University

Source of funding: NR

NCT01990677

Trial name or title

Eplerenone for the Treatment of Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: ≥ 18 years

Gender: men and women

Interventions

Intervention 1: eplerenone 25 mg ‐ chronic CSC diagnosis

"Dosing will begin at 25mg Eplerenone taken orally , one time, each day for 58 days. Throughout the 58 day treatment period dosage will be adjusted. The adjustment will be based on serum potassium and creatine levels from blood draws done at Day 12 and Day 33. From the 25 mg starting dosage, the dosage will either be increased to 50 mg a day or reduced to placebo, one time, each day"

Intervention 2: placebo ‐ chronic CSC diagnosis

"Dosing will begin with placebo and will stay as placebo throughout the study. The placebo pills will be taken orally, once daily, for 58 days. The placebo pills will be compounded to be of similar composition to the eplerenone tablets, without the active ingredient"

Intervention 3: eplerenone 25 mg ‐ acute CSC diagnosis

"Dosing will begin at 25mg Eplerenone taken orally , one time, each day for 28 days. Throughout the 28 day treatment period, dosage will be adjusted based on serum potassium and creatine levels from blood draws done on Day 12. From the 25 mg starting dosage, the dosage will either be increased to 50 mg a day or reduced to placebo, one time, each day"

Intervention 4: placebo ‐ acute CSC diagnosis

"Dosing will begin with placebo and will stay as placebo throughout the study. The placebo pills will be taken orally, once daily, for 28 days. The placebo pills will be compounded to be of similar composition to the eplerenone tablets, without the active ingredient"

Outcomes

Primary outcomes: absence of subfoveal (retinal) fluid based on spectral domain OCT measurement at 1 month in acute CSC and 2 months in chronic CSC participants

Secondary outcomes: mean change in subfoveal fluid height based on OCT measurement at 1 month in acute CSC and 2 months in chronic CSC participants

Starting date

October 2013

Contact information

Brian Burke, MPH

Wills Eye Hospital

Notes

Sponsor name: Wills Eye Hospital, Philadelphia, United States

Source of funding: NR

NCT02153125

Trial name or title

Eplerenone for the Treatment of Chronic Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: 18‐65 years

Gender: men and women

Interventions

Intervention 1: eplerenone 25 mg given daily for 1 week, followed by 50 mg given for a total of 3 months since commencement of treatment

Intervention 2: placebo

Outcomes

Primary outcomes: decrease of at least 10% in subretinal fluid thickness as measured by OCT at 6 months

Secondary outcomes: NR

Starting date

April 2014

Contact information

Michaella Goldstein, MD

Tel Aviv Souraski Medical Center, Israel

Notes

Sponsor name: Tel‐Aviv Sourasky Medical Center

Source of funding: NR

NCT02215330

Trial name or title

A Study of the Beneficial Effects of Eplerenone on Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: ≥ 21 years

Gender: men and women

Interventions

Intervention: eplerenone 25 mg pills triturated and filled into capsules

Control: sugar pill (maltodextrin filled into capsules)

Outcomes

Primary outcomes: difference in the number of successful treatments after 16 weeks, defined as complete absence of subretinal fluid on SD‐OCT

Secondary outcomes: change in visual acuity between eplerenone and placebo at 16 weeks, change in retinal thickness between eplerenone and placebo at 16 weeks, change in retinal volume between eplerenone and placebo at 16 weeks

Starting date

October 2014

Contact information

Oliver Findl, MD, Prof, MBA

Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology

Hanusch Hospital Vienna, Vienna, Austria

Notes

Sponsor name: Oliver Findl, MD, Prof, MBA

Source of funding: NR

NCT02354170

Trial name or title

Short‐Term Oral Mifepristone for Central Serous Chorioretinopathy

Methods

Study design: parallel group RCT

Participants

Population age: ≥ 18 years

Gender: men and woman

Interventions

Intervention 1: 1 x 300 mg mifepristone tablet, taken once daily for 4 weeks

Intervention 2: 3 x 300 mg mifepristone tablets (900 mg dose), taken once daily for 4 weeks

Control: placebo taken once daily for 4 weeks

Outcomes

Primary outcomes: resolution of sub‐retinal fluid at 4 weeks after treatment, presence or absence of subretinal fluid on spectral‐domain OCT after 4 weeks of treatment with mifepristone 300 or 900 mg daily, compared with placebo

Secondary outcomes: change in subretinal fluid or intraretinal fluid (or both) at weeks 1, 2, 4, and 8, BCVA at weeks 1, 2, 4, and 8, change in ETDRS BCVA compared with baseline at weeks 1, 2, 4, and 8, change in macular thickness at weeks 1, 2, 4, and 8, change in foveal thickness at weeks 1, 2, 4, and 8, change compared with baseline in thickness of subretinal fluid under the fovea on OCTat weeks 1, 2, 4, and 8, change in choroidal thickness at weeks 1, 2, 4, and 8, dye leakage in vasculature at week 4 and 8, change in OCT characteristics in the fellow eye at week 8, proportion of acute versus chronic CSC participants at week 8, proportion of acute versus chronic CSC participants as determined at baseline, with the above outcomes analyzed for each subgroup; safety and tolerability characteristics at week 8

Starting date

January 2015

Contact information

Roger A Goldberg, MD, MBA

Bay Area Retina Associates

Walnut Creek, California, United States

Jeffery S Heier, MD

Ophthalmic Consultants of Boston

Boston, Massachusetts, United States

Notes

Sponsor Name: Roger Goldberg, MD, MBA

Source of funding: Bay Area Retina Associates, Ophthalmic Consultants of Boston

BCVA: best‐corrected visual acuity; CSC: central serous chorioretinopathy (also known as CSR: central serous retinopathy); ETDRS: Early Treatment Diabetic Retinopathy Study; ICGA: indocyanine green angiography; NR: not reported; OCT: optical coherence tomography; PDT: photodynamic therapy; RCT: randomized controlled trial.

Data and analyses

Open in table viewer
Comparison 1. Anti‐VEGF versus observation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

64

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.02, 0.03]
Analysis 1.1
Comparison 1 Anti‐VEGF versus observation, Outcome 1 Mean change in BCVA at 12 months.

Comparison 1 Anti‐VEGF versus observation, Outcome 1 Mean change in BCVA at 12 months.

2 Mean change in CRT at 12 months Show forest plot

2

64

Mean Difference (IV, Fixed, 95% CI)

8.73 [‐18.08, 35.54]
Analysis 1.2
Comparison 1 Anti‐VEGF versus observation, Outcome 2 Mean change in CRT at 12 months.

Comparison 1 Anti‐VEGF versus observation, Outcome 2 Mean change in CRT at 12 months.
Open in table viewer
Comparison 2. Anti‐VEGF versus low fluence PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

56

Mean Difference (IV, Fixed, 95% CI)

0.03 [‐0.08, 0.15]
Analysis 2.1
Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 1 Mean change in BCVA at 12 months.

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 1 Mean change in BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.2
Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 2 Recurrence of CSC at 12 months.

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 2 Recurrence of CSC at 12 months.

3 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.3
Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 3 Persistent CSC at 12 months.

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 3 Persistent CSC at 12 months.

4 Mean change in CRT at 12 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.4
Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 4 Mean change in CRT at 12 months.

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 4 Mean change in CRT at 12 months.

Open in table viewer
Comparison 3. Anti‐VEGF plus 50% PDT versus 50% PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.1
Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

2 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.2
Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 2 Persistent CSC at 12 months.

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 2 Persistent CSC at 12 months.

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.3
Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 3 Mean change in CRT at 12 months.

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 3 Mean change in CRT at 12 months.

Open in table viewer
Comparison 4. Six‐dose anti‐VEGF versus four‐dose anti‐VEGF

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 4.1
Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 1 Mean change in BCVA at 12 months.

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 1 Mean change in BCVA at 12 months.

2 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 4.2
Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 2 Mean change in CRT at 12 months.

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 2 Mean change in CRT at 12 months.

Open in table viewer
Comparison 5. 50% PDT versus sham treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.1
Comparison 5 50% PDT versus sham treatment, Outcome 1 Mean BCVA at 12 months.

Comparison 5 50% PDT versus sham treatment, Outcome 1 Mean BCVA at 12 months.

2 Recurrence/persistence CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.2
Comparison 5 50% PDT versus sham treatment, Outcome 2 Recurrence/persistence CSC at 12 months.

Comparison 5 50% PDT versus sham treatment, Outcome 2 Recurrence/persistence CSC at 12 months.

2.1 Recurrence of CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 Persistent CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Mean CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.3
Comparison 5 50% PDT versus sham treatment, Outcome 3 Mean CRT at 12 months.

Comparison 5 50% PDT versus sham treatment, Outcome 3 Mean CRT at 12 months.
Open in table viewer
Comparison 6. 30% PDT versus PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.1
Comparison 6 30% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

Comparison 6 30% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 6.2
Comparison 6 30% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

Comparison 6 30% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.3
Comparison 6 30% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.

Comparison 6 30% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.
Open in table viewer
Comparison 7. 50% PDT versus PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 7.1
Comparison 7 50% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

Comparison 7 50% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 7.2
Comparison 7 50% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

Comparison 7 50% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 7.3
Comparison 7 50% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.

Comparison 7 50% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.
Open in table viewer
Comparison 8. 30% PDT versus 50% PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

177

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.15, ‐0.08]
Analysis 8.1
Comparison 8 30% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

Comparison 8 30% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

2

153

Risk Ratio (M‐H, Fixed, 95% CI)

2.50 [1.54, 4.06]
Analysis 8.2
Comparison 8 30% PDT versus 50% PDT, Outcome 2 Recurrence of CSC at 12 months.

Comparison 8 30% PDT versus 50% PDT, Outcome 2 Recurrence of CSC at 12 months.

3 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 8.3
Comparison 8 30% PDT versus 50% PDT, Outcome 3 Persistent CSC at 12 months.

Comparison 8 30% PDT versus 50% PDT, Outcome 3 Persistent CSC at 12 months.

4 Mean change in CRT at 12 months Show forest plot

2

177

Mean Difference (IV, Fixed, 95% CI)

44.90 [42.57, 47.23]
Analysis 8.4
Comparison 8 30% PDT versus 50% PDT, Outcome 4 Mean change in CRT at 12 months.

Comparison 8 30% PDT versus 50% PDT, Outcome 4 Mean change in CRT at 12 months.
Open in table viewer
Comparison 9. Laser versus observation or sham treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.1
Comparison 9 Laser versus observation or sham treatment, Outcome 1 Mean change in BCVA at 12 months.

Comparison 9 Laser versus observation or sham treatment, Outcome 1 Mean change in BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 9.2
Comparison 9 Laser versus observation or sham treatment, Outcome 2 Recurrence of CSC at 12 months.

Comparison 9 Laser versus observation or sham treatment, Outcome 2 Recurrence of CSC at 12 months.

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.3
Comparison 9 Laser versus observation or sham treatment, Outcome 3 Mean change in CRT at 12 months.

Comparison 9 Laser versus observation or sham treatment, Outcome 3 Mean change in CRT at 12 months.

Open in table viewer
Comparison 10. Indirect argon laser versus direct argon laser

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 10.1
Comparison 10 Indirect argon laser versus direct argon laser, Outcome 1 Recurrence of CSC at 12 months.

Comparison 10 Indirect argon laser versus direct argon laser, Outcome 1 Recurrence of CSC at 12 months.

Open in table viewer
Comparison 11. Comparison of different laser wavelengths

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 11.1
Comparison 11 Comparison of different laser wavelengths, Outcome 1 Recurrence of CSC at 12 months.

Comparison 11 Comparison of different laser wavelengths, Outcome 1 Recurrence of CSC at 12 months.

1.1 Yellow compared with red

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Yellow compared with green

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Red compared with green

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 12. Antioxidant supplements versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 12.1
Comparison 12 Antioxidant supplements versus placebo, Outcome 1 BCVA at 12 months.

Comparison 12 Antioxidant supplements versus placebo, Outcome 1 BCVA at 12 months.

2 Recurrence at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 12.2
Comparison 12 Antioxidant supplements versus placebo, Outcome 2 Recurrence at 12 months.

Comparison 12 Antioxidant supplements versus placebo, Outcome 2 Recurrence at 12 months.

3 Persistence at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 12.3
Comparison 12 Antioxidant supplements versus placebo, Outcome 3 Persistence at 12 months.

Comparison 12 Antioxidant supplements versus placebo, Outcome 3 Persistence at 12 months.

4 CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 12.4
Comparison 12 Antioxidant supplements versus placebo, Outcome 4 CRT at 12 months.

Comparison 12 Antioxidant supplements versus placebo, Outcome 4 CRT at 12 months.
Open in table viewer
Comparison 13. Beta‐blocker versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 13.1
Comparison 13 Beta‐blocker versus placebo, Outcome 1 Mean BCVA at 12 months.

Comparison 13 Beta‐blocker versus placebo, Outcome 1 Mean BCVA at 12 months.

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 13.2
Comparison 13 Beta‐blocker versus placebo, Outcome 2 Recurrence of CSC at 12 months.

Comparison 13 Beta‐blocker versus placebo, Outcome 2 Recurrence of CSC at 12 months.

3 BCVA ≥ 20/40 at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 13.3
Comparison 13 Beta‐blocker versus placebo, Outcome 3 BCVA ≥ 20/40 at 12 months.

Comparison 13 Beta‐blocker versus placebo, Outcome 3 BCVA ≥ 20/40 at 12 months.
Open in table viewer
Comparison 14. Carbonic anhydrase inhibitors versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrent/persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 14.1
Comparison 14 Carbonic anhydrase inhibitors versus placebo, Outcome 1 Recurrent/persistent CSC at 12 months.

Comparison 14 Carbonic anhydrase inhibitors versus placebo, Outcome 1 Recurrent/persistent CSC at 12 months.

1.1 Recurrence of CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Persistent CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 15. Helicobacter pylori treatment versus placebo or observation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

2

103

Mean Difference (IV, Fixed, 95% CI)

‐0.04 [‐0.07, ‐0.02]
Analysis 15.1
Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 1 Mean BCVA at 12 months.

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 1 Mean BCVA at 12 months.

2 Persistent CSC at 12 months Show forest plot

2

103

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.36, 1.22]
Analysis 15.2
Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 2 Persistent CSC at 12 months.

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 2 Persistent CSC at 12 months.

Theoretical treatment network.
Figures and Tables -
Figure 1

Theoretical treatment network.

Navigate to figure in ReviewOpen in new tab

Study flow diagram.
Figures and Tables -
Figure 2

Study flow diagram.

Navigate to figure in ReviewOpen in new tab

Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
Figures and Tables -
Figure 3

Risk of bias summary: review authors' judgments about each risk of bias item for each included study.

Navigate to figure in ReviewOpen in new tab

Visual acuity network: network plot, interval plot, contribution matrix and risk of bias.AVG: Anti‐VEGF PDT: photodynamic therapy LAS: laser AVPDT: anti‐VEGF plus PDT.1 = control; 2 = anti‐VEGF; 3 = PDT; 4 = laser; 5 = anti‐VEGF plus PDT.
Figures and Tables -
Figure 4

Visual acuity network: network plot, interval plot, contribution matrix and risk of bias.

AVG: Anti‐VEGF PDT: photodynamic therapy LAS: laser AVPDT: anti‐VEGF plus PDT.

1 = control; 2 = anti‐VEGF; 3 = PDT; 4 = laser; 5 = anti‐VEGF plus PDT.

Navigate to figure in ReviewOpen in new tab

Recurrence CSC network: network plot, interval plot, contribution matrix and risk of bias.AVG: Anti‐VEGF; PDT: photodynamic therapy; LAS: laser: CTL: control.1 = control; 2 = anti‐VEGF; 3 = PDT; 4 = laser.
Figures and Tables -
Figure 5

Recurrence CSC network: network plot, interval plot, contribution matrix and risk of bias.

AVG: Anti‐VEGF; PDT: photodynamic therapy; LAS: laser: CTL: control.

1 = control; 2 = anti‐VEGF; 3 = PDT; 4 = laser.

Navigate to figure in ReviewOpen in new tab

Comparison 1 Anti‐VEGF versus observation, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 1.1

Comparison 1 Anti‐VEGF versus observation, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 1 Anti‐VEGF versus observation, Outcome 2 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 1.2

Comparison 1 Anti‐VEGF versus observation, Outcome 2 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 2.1

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 2.2

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 3 Persistent CSC at 12 months.
Figures and Tables -
Analysis 2.3

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 3 Persistent CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 4 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 2.4

Comparison 2 Anti‐VEGF versus low fluence PDT, Outcome 4 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 3.1

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 2 Persistent CSC at 12 months.
Figures and Tables -
Analysis 3.2

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 2 Persistent CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 3 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 3.3

Comparison 3 Anti‐VEGF plus 50% PDT versus 50% PDT, Outcome 3 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 4.1

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 2 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 4.2

Comparison 4 Six‐dose anti‐VEGF versus four‐dose anti‐VEGF, Outcome 2 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 5 50% PDT versus sham treatment, Outcome 1 Mean BCVA at 12 months.
Figures and Tables -
Analysis 5.1

Comparison 5 50% PDT versus sham treatment, Outcome 1 Mean BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 5 50% PDT versus sham treatment, Outcome 2 Recurrence/persistence CSC at 12 months.
Figures and Tables -
Analysis 5.2

Comparison 5 50% PDT versus sham treatment, Outcome 2 Recurrence/persistence CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 5 50% PDT versus sham treatment, Outcome 3 Mean CRT at 12 months.
Figures and Tables -
Analysis 5.3

Comparison 5 50% PDT versus sham treatment, Outcome 3 Mean CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 6 30% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.
Figures and Tables -
Analysis 6.1

Comparison 6 30% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 6 30% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 6.2

Comparison 6 30% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 6 30% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 6.3

Comparison 6 30% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 7 50% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.
Figures and Tables -
Analysis 7.1

Comparison 7 50% PDT versus PDT, Outcome 1 Mean BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 7 50% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 7.2

Comparison 7 50% PDT versus PDT, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 7 50% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 7.3

Comparison 7 50% PDT versus PDT, Outcome 3 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 8 30% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 8.1

Comparison 8 30% PDT versus 50% PDT, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 8 30% PDT versus 50% PDT, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 8.2

Comparison 8 30% PDT versus 50% PDT, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 8 30% PDT versus 50% PDT, Outcome 3 Persistent CSC at 12 months.
Figures and Tables -
Analysis 8.3

Comparison 8 30% PDT versus 50% PDT, Outcome 3 Persistent CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 8 30% PDT versus 50% PDT, Outcome 4 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 8.4

Comparison 8 30% PDT versus 50% PDT, Outcome 4 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Laser versus observation or sham treatment, Outcome 1 Mean change in BCVA at 12 months.
Figures and Tables -
Analysis 9.1

Comparison 9 Laser versus observation or sham treatment, Outcome 1 Mean change in BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Laser versus observation or sham treatment, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 9.2

Comparison 9 Laser versus observation or sham treatment, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Laser versus observation or sham treatment, Outcome 3 Mean change in CRT at 12 months.
Figures and Tables -
Analysis 9.3

Comparison 9 Laser versus observation or sham treatment, Outcome 3 Mean change in CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 10 Indirect argon laser versus direct argon laser, Outcome 1 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 10.1

Comparison 10 Indirect argon laser versus direct argon laser, Outcome 1 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 11 Comparison of different laser wavelengths, Outcome 1 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 11.1

Comparison 11 Comparison of different laser wavelengths, Outcome 1 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 12 Antioxidant supplements versus placebo, Outcome 1 BCVA at 12 months.
Figures and Tables -
Analysis 12.1

Comparison 12 Antioxidant supplements versus placebo, Outcome 1 BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 12 Antioxidant supplements versus placebo, Outcome 2 Recurrence at 12 months.
Figures and Tables -
Analysis 12.2

Comparison 12 Antioxidant supplements versus placebo, Outcome 2 Recurrence at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 12 Antioxidant supplements versus placebo, Outcome 3 Persistence at 12 months.
Figures and Tables -
Analysis 12.3

Comparison 12 Antioxidant supplements versus placebo, Outcome 3 Persistence at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 12 Antioxidant supplements versus placebo, Outcome 4 CRT at 12 months.
Figures and Tables -
Analysis 12.4

Comparison 12 Antioxidant supplements versus placebo, Outcome 4 CRT at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 13 Beta‐blocker versus placebo, Outcome 1 Mean BCVA at 12 months.
Figures and Tables -
Analysis 13.1

Comparison 13 Beta‐blocker versus placebo, Outcome 1 Mean BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 13 Beta‐blocker versus placebo, Outcome 2 Recurrence of CSC at 12 months.
Figures and Tables -
Analysis 13.2

Comparison 13 Beta‐blocker versus placebo, Outcome 2 Recurrence of CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 13 Beta‐blocker versus placebo, Outcome 3 BCVA ≥ 20/40 at 12 months.
Figures and Tables -
Analysis 13.3

Comparison 13 Beta‐blocker versus placebo, Outcome 3 BCVA ≥ 20/40 at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 14 Carbonic anhydrase inhibitors versus placebo, Outcome 1 Recurrent/persistent CSC at 12 months.
Figures and Tables -
Analysis 14.1

Comparison 14 Carbonic anhydrase inhibitors versus placebo, Outcome 1 Recurrent/persistent CSC at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 1 Mean BCVA at 12 months.
Figures and Tables -
Analysis 15.1

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 1 Mean BCVA at 12 months.

Navigate to figure in ReviewOpen in new tab

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 2 Persistent CSC at 12 months.
Figures and Tables -
Analysis 15.2

Comparison 15 Helicobacter pylori treatment versus placebo or observation, Outcome 2 Persistent CSC at 12 months.

Navigate to figure in ReviewOpen in new tab
Summary of findings for the main comparison. Interventions for central serous chorioretinopathy: direct comparisons

Interventions for central serous chorioretinopathy: direct comparisons

Patient or population: people with central serous chorioretinopathy

Settings: eye hospital

Comparison

(intervention vs. comparator)

Anticipated absolute effects (95% CI)

Effect estimate from direct comparison

Comments

Relative effect
(95% CI)

No of participants
(studies)

Quality

Risk with comparator

Mean difference (95% CI) Negative values are in favor of intervention; positive values in favor of comparator

Change in visual acuity at 12 months (logMAR)

Anti‐VEGF vs. observation

‐

0.01 LogMAR (‐0.02 to 0.03)

‐

64 (2)

Low1,2

Both studies enrolled participants with acute CSC and reported mean change in visual acuity at 6 months

Anti‐VEGF vs. low‐fluence PDT

‐

0.03 logMAR (‐0.08 to 0.15)

‐

56 (2)

Low1,2

Both studies enrolled participants with chronic CSC

Anti‐VEGF and 50% PDT vs. 50% PDT

‐

0.30 logMAR (0.09 to 0.51)

‐

15 (1)

Low1,2

Participants had chronic CSC

6‐dose anti‐VEGF vs. 4‐dose anti‐VEGF

‐

‐0.02 logMAR (‐0.31 to 0.27)

‐

12 (1)

Low1,2

Participants had chronic CSC and were followed to 6 months

50% PDT vs. observation or sham treatment

‐

‐0.10 logMAR (‐0.18 to ‐0.02)

‐

58 (1)

Low1,2

Participants had acute CSC

30% PDT vs. PDT

‐

‐0.16 logMAR (‐0.22 to ‐0.10)

‐

60 (1)

Low1,2

Type of CSC not specified

30% PDT vs. 50% PDT

‐

‐0.12 logMAR (‐0.15 to ‐0.08)

‐

60 (1)

Low1,2

Type of CSC not specified

50% PDT vs. PDT

‐

0.04 logMAR (‐0.04 to 0.12

‐

60 (1)

Low1,2

Type of CSC not specified

Selective retina therapy vs. observation

‐

‐0.13 logMAR (‐0.24 to ‐0.01)

‐

30 (1)

Low1,2

Participants had acute CSC, followed up to 3 months

Micropulse diode laser vs. sham laser

‐

‐0.38 logMAR (‐0.56 to ‐0.20)

‐

15 (1)

Low1,2

Participants had chronic CSC

Antioxidant vs. placebo

‐

0.01 logMAR (‐0.04 to 0.06)

‐

14 (1)

Low1,2

Lutein and acute CSC

Propranolol vs. placebo

‐

0.01 logMAR (‐0.07 to 0.09)

‐

60 (1)

Low1,2

Type of CSC not specified

Carbonic anhydrase inhibitors vs. placebo

See comment

‐

‐

13 (1)

‐

Outcome not reported

Helicobacter pylori treatment vs. placebo

‐

‐0.04 logMAR (‐0.07 to ‐0.02)

‐

103 (2)

Low1,2

Participants had acute CSC, follow‐up 12‐16 weeks

Comparison

(intervention vs. comparator)

Anticipated absolute effects (95% CI)

Effect estimate from direct comparison

Comments

Risk with comparator*

Risk with intervention

Relative effect (95% CI)

No of participants
(studies)

Quality

Persistent CSC at 12 months

Anti‐VEGF vs. observation

See comment

‐

‐

64 (2)

‐

Participants had acute CSC. Both trials reported that all participants in treatment and control groups were resolved by 6 months

Anti‐VEGF vs. low‐fluence PDT

111 per 1000

688 per 1000 (179 to 1000)

RR 6.19 (1.61 to 23.81)

34 (1)

Low1,2

Participants had chronic CSC

Anti‐VEGF and 50% PDT vs. 50% PDT

143 per 1000

126 (10 to 1000)

RR 0.88 (0.07 to 11.54)

15 (1)

Very low1,2,3

Participants had chronic CSC

6‐dose anti‐VEGF vs. 4‐dose anti‐VEGF

See comment

‐

‐

12 (1)

‐

Outcome not reported

50% PDT vs. sham treatment

211 per 1000

25 per 1000 (2 to 215)

RR 0.12 (0.01 to 1.02)

58 (1)

Low1,2

Participants had acute CSC

30% PDT vs. PDT

See comment

‐

‐

60 (1)

‐

Outcome not reported

30% PDT vs. 50% PDT

See comment

‐

‐

60 (1)

‐

Outcome not reported

50% PDT vs. PDT

See comment

‐

‐

60 (1)

‐

Outcome not reported

Selective retina therapy vs. observation

See comment

‐

‐

30 (1)

‐

Outcome not reported

Micropulse diode laser

See comment

‐

‐

15 (1)

‐

Outcome not reported

Antioxidant vs. placebo

See comment

‐

‐

51 (1)

‐

People in the antioxidant group were less likely to have "complete resolution" at 3 months (RR 0.35, 95% CI 0.13 to 0.95; 51 participants)

Propranolol vs. placebo

See comment

‐

‐

60 (1)

‐

Outcome not reported

Brinzolamide vs. placebo

167 per 1000

48 (2 to 1000)

RR 0.29 (0.01 to 6.07)

13 (1)

Very low2,3

Participants had acute CSC

Helicobacter pylori treatment vs. placebo

314 per 1000

210 (113 to 383)

RR 0.67 (0.36 to 1.22)

103 (2)

Low1,2

Participants had acute CSC

Comparison

(intervention vs. comparator)

Anticipated absolute effects (95% CI)

Effect estimate from direct comparison

Risk with comparator*

Risk with intervention

Relative effect (95% CI)

No of participants
(studies)

Quality

Comment

Recurrent CSC at 12 months

Anti‐VEGF vs. observation

See comment

‐

‐

64 (2)

‐

Outcome not reported

Anti‐VEGF vs. low‐fluence PDT

See comment

‐

‐

56 (2)

Very low1,2,4

Participants had chronic CSC. The 2 studies had different results for this outcome (I2 = 71%). In Bae 2011, there was a much higher risk of recurrence in the anti‐VEGF group (ranibizumab) compared with the PDT group (RR 19.83, 95% CI 1.19 to 330.50; 21 eyes); in Semeraro 2012, there was also an increased risk of recurrence in the anti‐VEGF (bevacizumab) group but the size of the effect was much smaller and the CIs include 1 (no effect) (RR 1.46, 95% CI 0.59 to 3.58; 22 eyes)

Anti‐VEGF and 50% PDT vs. 50% PDT

See comment

‐

‐

15 (1)

‐

Outcome not reported

6‐dose anti‐VEGF vs. 4‐dose anti‐VEGF

See comment

‐

‐

12 (1)

‐

Outcome not reported

50% PDT vs. sham treatment

267 per 1000

27 per 1000 (3 to 216)

RR 0.10 (0.01 to 0.81)

53 (1)

Low1,2

Participants had acute CSC

30% PDT vs. PDT

See comment

‐

‐

60 (1)

‐

Outcome not reported

30% PDT vs. 50% PDT

See comment

‐

‐

60 (1)

‐

Outcome not reported

50% PDT vs. PDT

270 per 1000

338 per 1000 (154 to 737)

RR 1.25 (0.57 to 2.73)

60 (1)

‐

Type of CSC not specified

Selective retina therapy vs. observation

See comment

‐

‐

30 (1)

‐

Outcome not reported

Micropulse diode laser

See comment

‐

‐

15 (1)

‐

Outcome not reported

Antioxidant vs. placebo

143 per 1000

46 (4 to 456)

RR 0.32 (0.03 to 3.19)

36 (1)

Very low2,3

Participants had acute CSC

Propranolol vs. placebo

167 per 1000

100 (27 to 382)

RR 0.60 (0.16 to 2.29)

60 (1)

Low1,2

Type of CSC not reported

Brinzolamide vs. placebo

314 per 1000

140 (20 to 953)

RR 0.21 (0.03 to 1.43

13 (1)

Low1,2

Participants had acute CSC

Helicobacter pylori treatment vs. placebo

See comment

‐

‐

103 (2)

‐

Outcome not reported

Adverse effects

All studies reported no ocular or systematic adverse effects, or did not comment on adverse effects

anti‐VEGF: anti‐vascular endothelial growth factor; CI: confidence interval; CSC: central serous chorioretinopathy; logMAR: logarithm of the minimal angle of resolution; PDT: photodynamic therapy; RR: risk ratio.

* Risk was estimated from the comparator group in the included studies

1 Downgraded for imprecision (‐1)

2 Downgraded for risk of bias (‐1)

3 Downgraded for imprecision (‐2)

4 Downgraded for inconsistency (‐1)
Figures and Tables -
Summary of findings for the main comparison. Interventions for central serous chorioretinopathy: direct comparisons
Navigate to table in Review
Table 1. Assessment of transitivity across treatment comparisons: visual acuity

Treatment comparison

Study

Type of CSC

Date study conducted

Industry sponsored

Anti‐VEGF vs. PDT

Bae 2011

Semeraro 2012

Chronic

Chronic

2009‐2012

2009‐2010

Yes

NR

PDT vs. no treatment

Chan 2008

Acute

2004‐2005

NR

Laser vs. no treatment

Robertson 1983

Acute

1977‐1981

No

One additional study for the comparison PDT vs. no treatment was reported in abstract form only and no data on outcome so was not included in the network meta‐analysis (Boscia 2008).

anti‐VEGF: anti‐vascular endothelial growth factor; CSC: central serous chorioretinopathy; NR: not reported; PDT: photodynamic therapy.

Figures and Tables -
Table 1. Assessment of transitivity across treatment comparisons: visual acuity
Navigate to table in Review
Table 2. Comparative effects of ocular interventions for central serous chorioretinopathy: visual acuity

Anti‐VEGF

‐0.08 (‐0.14 to ‐0.01)

‐0.20 (‐0.30 to ‐0.11)

0.00 (‐0.02 to 0.03)

0.22 (0.01 to 0.44)

0.08 (0.01 to 0.14)

PDT

‐0.13 (‐0.24 to ‐0.01)

0.08 (0.01 to 0.15)

0.30 (0.09 to 0.51)

0.20 (0.11 to 0.30)

0.13 (0.01 to 0.24)

Laser

0.21 (0.11 to 0.31)

0.43 (0.19 to 0.66)

‐0.00 (‐0.03 to 0.02)

‐0.08 (‐0.15 to ‐0.01)

‐0.21 (‐0.31 to ‐0.11)

Anti‐VEGF and PDT

0.22 (0.00 to 0.44)

‐0.22 (‐0.44 to ‐0.01)

‐0.30 (‐0.51 to ‐0.09)

‐0.43 (‐0.66 to ‐0.19)

‐0.22 (‐0.44 to ‐0.00)

Control (no treatment or sham treatment)

Effect estimate is the mean difference (95% confidence interval). Negative values favor the first intervention. In the lower left hand triangle, the first intervention is anti‐VEGF, PDT, laser etc. In the upper right hand triangle, the first intervention is control, anti‐VEGF and PDT, laser etc. So, for example, visual acuity with anti‐VEGF was 0.22 logMAR units better than control 95% CI 0.44 better to 0.01 better.

anti‐VEGF: anti‐vascular endothelial growth factor; logMAR: logarithm of the minimal angle of resolution; PDT: photodynamic therapy.

Figures and Tables -
Table 2. Comparative effects of ocular interventions for central serous chorioretinopathy: visual acuity
Navigate to table in Review
Table 3. Assessment of transitivity across treatment comparisons: recurrence

Treatment comparison

Study

Type of CSC

Date study conducted

Industry sponsored

Anti‐VEGF vs. no treatment

Kim 2013

Lim 2010

Acute

Acute

2010‐2011

2008

No

No

Anti‐VEGF vs. PDT

Bae 2011

Semeraro 2012

Chronic

Chronic

2009‐2012

2009‐2010

Yes

NR

Anti‐VEGF + PDT vs. PDT alone

Coskun 2014

Chronic

NR (published 2014)

NR

PDT vs. no treatment

Chan 2008

Acute

2004‐2005

NR

Laser vs. no treatment

Klatt 2011

Robertson 1983

Roisman 2013

Acute

Acute

Chronic

2007‐2008

1977‐1981

NR (published 2013)

NR

No

NR

One additional study for the comparison PDT vs no treatment was reported in abstract form only and no data on outcome so was not included in the network meta‐analysis (Boscia 2008).

anti‐VEGF: anti‐vascular endothelial growth factor; CSC: central serous chorioretinopathy; NR: not reported; PDT: photodynamic therapy.

Figures and Tables -
Table 3. Assessment of transitivity across treatment comparisons: recurrence
Navigate to table in Review
Table 4. Comparative effects of ocular interventions for CSC: recurrence

Anti‐VEGF

0.27 (0.02 to 3.73)

3.34 (0.01 to 788.57)

2.67 (0.03 to 234.08)

3.77 (0.27 to 52.94)

PDT

12.58 (0.11 to 1503.87)

10.07 (0.27 to 371.91)

0.30 (0.00 to 70.79)

0.08 (0.00 to 9.50)

Laser

0.80 (0.03 to 18.46)

0.37 (0.00 to 32.83)

0.10 (0.00 to 3.67)

1.25 (0.05 to 28.85)

Control

Effect estimate is the risk ratio (95% CI).

anti‐VEGF: anti‐vascular endothelial growth factor; logMAR: logarithm of the minimal angle of resolution; PDT: photodynamic therapy.

Figures and Tables -
Table 4. Comparative effects of ocular interventions for CSC: recurrence
Navigate to table in Review
Comparison 1. Anti‐VEGF versus observation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

64

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.02, 0.03]

2 Mean change in CRT at 12 months Show forest plot

2

64

Mean Difference (IV, Fixed, 95% CI)

8.73 [‐18.08, 35.54]
Figures and Tables -
Comparison 1. Anti‐VEGF versus observation
Navigate to table in Review
Comparison 2. Anti‐VEGF versus low fluence PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

56

Mean Difference (IV, Fixed, 95% CI)

0.03 [‐0.08, 0.15]

2 Recurrence of CSC at 12 months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Mean change in CRT at 12 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 2. Anti‐VEGF versus low fluence PDT
Navigate to table in Review
Comparison 3. Anti‐VEGF plus 50% PDT versus 50% PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 3. Anti‐VEGF plus 50% PDT versus 50% PDT
Navigate to table in Review
Comparison 4. Six‐dose anti‐VEGF versus four‐dose anti‐VEGF

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 4. Six‐dose anti‐VEGF versus four‐dose anti‐VEGF
Navigate to table in Review
Comparison 5. 50% PDT versus sham treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence/persistence CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 Recurrence of CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 Persistent CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Mean CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 5. 50% PDT versus sham treatment
Navigate to table in Review
Comparison 6. 30% PDT versus PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 6. 30% PDT versus PDT
Navigate to table in Review
Comparison 7. 50% PDT versus PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 7. 50% PDT versus PDT
Navigate to table in Review
Comparison 8. 30% PDT versus 50% PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

177

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.15, ‐0.08]

2 Recurrence of CSC at 12 months Show forest plot

2

153

Risk Ratio (M‐H, Fixed, 95% CI)

2.50 [1.54, 4.06]

3 Persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Mean change in CRT at 12 months Show forest plot

2

177

Mean Difference (IV, Fixed, 95% CI)

44.90 [42.57, 47.23]
Figures and Tables -
Comparison 8. 30% PDT versus 50% PDT
Navigate to table in Review
Comparison 9. Laser versus observation or sham treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA at 12 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Mean change in CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 9. Laser versus observation or sham treatment
Navigate to table in Review
Comparison 10. Indirect argon laser versus direct argon laser

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 10. Indirect argon laser versus direct argon laser
Navigate to table in Review
Comparison 11. Comparison of different laser wavelengths

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Yellow compared with red

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Yellow compared with green

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Red compared with green

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 11. Comparison of different laser wavelengths
Navigate to table in Review
Comparison 12. Antioxidant supplements versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Persistence at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 CRT at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 12. Antioxidant supplements versus placebo
Navigate to table in Review
Comparison 13. Beta‐blocker versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Recurrence of CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 BCVA ≥ 20/40 at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figures and Tables -
Comparison 13. Beta‐blocker versus placebo
Navigate to table in Review
Comparison 14. Carbonic anhydrase inhibitors versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrent/persistent CSC at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Recurrence of CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Persistent CSC at 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 14. Carbonic anhydrase inhibitors versus placebo
Navigate to table in Review
Comparison 15. Helicobacter pylori treatment versus placebo or observation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BCVA at 12 months Show forest plot

2

103

Mean Difference (IV, Fixed, 95% CI)

‐0.04 [‐0.07, ‐0.02]

2 Persistent CSC at 12 months Show forest plot

2

103

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.36, 1.22]
Figures and Tables -
Comparison 15. Helicobacter pylori treatment versus placebo or observation
Navigate to table in Review