Central Serous Chorioretinopathy: Current Concepts in Pathogenesis, Multimodal Imaging, and Management

Central serous chorioretinopathy (CSC) is a retinal disorder characterised by serous detachment of the neurosensory retina. It results from dysfunction of the retinal pigment epithelium and derangements in choroidal circulation. Once regarded as a benign and self-limiting macular disease of young men, CSC is now recognised as part of a broader pachychoroid spectrum in which choroidal vascular congestion, venous overload, and hyperpermeability play crucial roles. Multimodal imaging, including optical coherence tomography (OCT), fundus autofluorescence, indocyanine green angiography, and OCT-angiography, have significantly altered the understanding of this condition and allowed early identification of chronicity and complications such as choroidal neovascularisation. Management strategies continue to evolve. Although the availability of photodynamic therapy may be limited in some settings, micropulse laser, focal thermal laser, anti-vascular endothelial growth factor therapy, and selected systemic medications continue to have important roles in specific clinical scenarios. This narrative review provides an updated synthesis of current knowledge regarding CSC, emphasising its pathogenesis, clinical presentation, imaging findings, complications, and therapeutic approaches.