Pradeep Kumar Panigrahi1. 1. Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (deemed to be) University, Bhubaneswar, Odisha, India.
Dear Editor,I read the article titled “Effect of short-term meditation training in central serous chorioretinopathy” by Nongrem et al.[1] I congratulate the authors for their publication. I have a few observations. In the results section, the authors have mentioned that the median duration of symptoms was 4 months (range: 7 days–2 years). This suggests that patients with both acute and chronic (non-resolving) central serous chorioretinopathy (CSC) were included in the two groups. Mixing up patients with both acute and chronic symptoms makes the study population heterogeneous. It would have been better if only either acute or chronic CSC patients had been included. A majority of patients with acute CSC undergo spontaneous resolution of subretinal fluid. If more number of patients with acute CSC are present in one particular group, then the results can get skewed in favor of that group. In the discussion part, the authors have made a statement that “in this study, the beneficial effects of short-term meditation training on the anatomical and functional outcomes in cases with acute CSC are documented and compared with those who did not receive any meditation therapy.” I find this statement contradictory as the study also included chronic cases with symptoms close to 2 years.The authors have not mentioned if the non-resolving cases had undergone any treatment in the past. They have clearly mentioned that FFA showed leakage in all cases with CSC at baseline. I think those patients with non-resolving CSC and no history of any previous treatment should not have been included in the study and should have been given the benefit of undergoing laser photocoagulation if there were no contraindications for the procedure. Endogenous cortisol level is associated with increased risk of CSC.[2] A previous study has shown that meditation interventions can bring about a reduction in endogenous cortisol levels in at-risk patients.[3] Future studies can measure endogenous cortisol levels before and after meditation and correlate the change in their levels with various ocular parameters in patients with CSC.