{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:10:23Z","timestamp":1790835023831,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Treatment of chronic central serous chorioretinopathy (cCSC) remains a topic of controversy. As cCSC is a disease that can wax and wane, treatment efficacy is difficult to assess especially when trials compare active treatments without any placebo\/control group. In this study, we systematically reviewed short\u2010term efficacies of any cCSC treatment tested in randomized controlled trials (RCT) and employed network meta\u2010analyses to compare to non\u2010treatment controls. We searched 11 literature databases on 20 March 2022 for RCTs of treatment of cCSC. We identified 17 RCTs including a total of 1172 eyes. Treatments included conventional laser (44 eyes), half\u2010dose or half\u2010fluence photodynamic therapy (PDT) (298 eyes), ranibizumab (16 eyes), antioxidants (50 eyes), mineralocorticoid receptor antagonists (187 eyes), rifampicin (91 eyes), selective retina therapy (SRT) (67 eyes) and subthreshold micropulse laser (192 eyes). Compared with controls, significant benefit on complete subretinal fluid resolution was only obtained from half\u2010dose or half\u2010fluence PDT (OR: 20.6; 95% CI: 6.3\u201366.7; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and conventional laser (OR: 36.4; 95% CI: 2.0\u2013655.7; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015), and at an order of magnitude lower degree from SRT (OR: 3.4; 95% CI: 1.7\u20136.8; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.00075). Compared with controls and after sensitivity analyses, significant benefit in the change in best\u2010corrected visual acuity was only obtained by half\u2010dose\/\u2010fluence PDT (\u22120.13 logMAR; 95% CI: \u22120.20 to \u22120.06 logMAR; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.00021). In conclusion, three treatment options provide significant improvement over no treatment: half\u2010dose\/\u2010fluence PDT, conventional laser and to a much lesser degree SRT. Considering that conventional laser can only be applied for extrafoveal leaks, and the long\u2010term data available for PDT\u2010based treatments finding persisting treatment results, half\u2010dose or half\u2010fluence PDT is the only viable treatment option for patients with cCSC. Shortage issues with verteporfin should not lead to employment of ineffective treatment modalities, as they put patients at unnecessary risk of adverse events.<\/jats:p>","DOI":"10.1111\/aos.15263","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T12:14:09Z","timestamp":1664540049000},"page":"140-159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Comparative efficacy of treatments for chronic central serous chorioretinopathy: A systematic review with network <scp>meta\u2010analyses<\/scp>"],"prefix":"10.1111","volume":"101","author":[{"given":"Elon H. C.","family":"van Dijk","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Ophthalmology Haga Hospital  The Hague The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena M. 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