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

Network meta-analysis of randomized trials in adults with central serous chorioretinopathy diagnosed by optical coherence tomography or fluorescein angiography. The evidence base included acute and chronic CSC across multiple countries, usually one eye per participant, and most participants were men.

High-dose antioxidant supplementation was one of the interventions assessed in this network meta-analysis of central serous chorioretinopathy, typically compared with placebo. The review did not identify a single standardized antioxidant formulation or dose that could be assigned across studies.

Overall, the review did not find strong enough evidence to recommend one treatment over another for central serous chorioretinopathy. Evidence quality was low or very low, and the trials were too small and heterogeneous to support robust comparisons. Observation remained a reasonable initial strategy for acute CSC, and the data were insufficient to make definitive choices among interventions such as photodynamic therapy, laser therapies, anti-VEGF agents, or systemic/oral medications. In the antioxidant trials, effects on vision and retinal thickness were small or imprecise, with limited and inconsistent evidence on persistence or recurrence.

The evidence base was limited by small sample sizes, substantial heterogeneity, and low or very low certainty. Trials used different CSC definitions, durations, interventions, and outcome measures, with inconsistent reporting of persistence, recurrence, and adverse events. Follow-up was often limited, and indirect network comparisons reduce confidence in any apparent treatment ranking.