Comparative efficacy and safety of multiple acupoint electrical stimulation therapies for postoperative cognitive dysfunction in cancer patients: a network meta-analysis.

Central serous chorioretinopathy (CSC) is characterized by neurosensory detachment with subretinal fluid (SRF) with or without pigment epithelial detachment (PED), usually associated with retinal pigment epithelium (RPE) dysfunction, choroidal thickening, hyperpermeability and venous overload. The disease affects mainly young to middle-aged men; although most cases can resolve spontaneously within 6 months, some patients progress to the chronic phase and have persistent SRF and visual impairment []. Photodynamic therapy (PDT), subthreshold micropulse laser (SML) therapy, and oral mineralocorticoid receptor antagonist (MRA) have been reported as options for treating CSCs. Since the wide variety of disease presentations and clinical courses and the current lack of consensus regarding therapy, controversy regarding the treatment of CSC remains []. Increasing evidence in recent years supports the use of half-dose PDT as the preferred therapeutic option for chronic CSC, but this approach is limited by the shortage of verteporfin. Other common alternative treatments in China include SML and oral MRA, but compelling evidence supporting the efficacy of SML and oral MRA is currently lacking, and therapeutic options should be evaluated on a case-by-case basis []. Previous studies have reported multiple factors that may be helpful for predicting the course and outcomes of CSC, such as the age of disease onset, incidence of macular complications, choroidal thickness, vascularity index, and presence of an intact ellipsoid zone []. However, based on differences in the mechanism of SML and oral MRA, there may be specific predictive factors corresponding to different therapies. To our knowledge, no study has reported comparison criteria. These would be of clinical importance as possibly different benefit identifications for CSC patients from SML or oral MRA therapies. The aim of this study was to evaluate CSC patients treated with SML therapy or oral spironolactone to identify possibly specific predictive factors corresponding to treatment response.