Interventions for central serous chorioretinopathy: a network meta-analysis.

Network meta-analysis of randomized trials in adults with acute or chronic central serous chorioretinopathy across multiple countries. Most included participants were men, and studies varied in CSC chronicity definitions, follow-up, and intervention type.

This network meta-analysis compared a broad range of central serous chorioretinopathy interventions rather than a single supplement regimen, including photodynamic therapy, anti-VEGF injections, laser approaches, brinzolamide, Helicobacter pylori eradication therapy, antioxidants, and lutein.

No intervention had sufficiently strong evidence to support a robust comparative recommendation. Most comparisons were based on only a few small trials with low or very low certainty evidence, so apparent benefits were not reliable enough to change practice broadly. Observation remained a reasonable initial management option for acute CSC, and no contraindication to observation was identified. Safety data were sparse because adverse events were rarely reported.

The evidence base was small and fragmented, with few trials per comparison and generally small sample sizes. Included studies used heterogeneous CSC definitions, intervention protocols, and outcome measures, and adverse events were infrequently reported, limiting certainty and generalizability.