National study on the management of central serous chorioretinopathy.

Background and objectives: To assess the perception and management of central serous chorioretinopathy (CSCR) in Spain through a survey aimed at retinal specialists.

Material and methods: The working group designed an original online survey, including 42 questions categorized into 4 sections: clinical perception, diagnosis, clinical management, and prognosis.

Results: A total of 114 ophthalmologists completed the survey. The mean age was 46 years (range, 26-72), 54.5% were men, and the mean post-residency experience was 17.5 years. CSCR was perceived as a growing condition by 80% of participants. While 75% believed acute CSCR tends to resolve spontaneously, 63% estimated chronicity in <25% of cases; however, if chronicity occurs, 77% considered spontaneous resolution unlikely without treatment. Besides OCT, OCT angiography was the most used diagnostic imaging modalitu (72%), followed by fundus autofluorescence (65%). Systemic work-up was never considered by 30%, while 62% would only consider it in the presence of bilateral or multifocal cases, with cortisol being the most frequently investigated parameter. Observation is preferred in acute CSCR, while photodynamic therapy is favored in chronic forms. Focal laser and anti-VEGF agents are preferred for extrafoveal leaks and neovascular membranes, respectively. While 80% expect anatomical improvement with treatment, there is consensus on its limited functional benefits.

Conclusions: This survey highlights that CSCR is perceived as an increasingly prevalent disease with high recurrence and potential for chronicity. It also reveals preferences and variability in its management among specialists.