The stress response as a target for treatment of central serous chorioretinopathy

Abstract

Central serous chorioretinopathy (CSC) is a visually debilitating disorder predominantly affecting males of working age. Currently, the mechanisms of disease are incompletely understood and consequently there is a paucity of treatment options available to manage CSC. In this article, we review the evidence for stress in disease pathogenesis and we use this as a framework to highlight potential therapeutic targets for treating CSC.

Keywords::

• HPA
• glucocorticoids
• central serous chorioretinopathy
• stress
• sympathetic nervous system

Acknowledgments

The authors would like to thank M Wright, Princess Alexandra Eye Pavilion, Edinburgh, UK for his contribution towards the images and S Gairns and M Brannon, Department of Medical Photography, Princess Alexandra Eye Pavilion, Edinburgh, UK for the capture of images shown in this article.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Central serous chorioretinopathy (CSC) is a visually debilitating disease commonly affecting working age males.

• • CSC pathogenesis/pathophysiology is incompletely understood.

• • The stress response is implicated in disease pathogenesis.

• • CSC is linked to increased exogenous and endogenous corticosteroids as well as diseases that result in raised stress.

• • Possible therapeutic targets include glucocorticoids, mineralocorticoids, epinephrine receptors, choroidal blood vasculature, the retinal pigment epithelium and modifiers of the hypothalamo-pituitary axis.

Notes