Dear Editor,
We read with great interest the article titled “Effect of short-term meditation training in central serous chorioretinopathy”[1] and congratulate the authors for an intriguing perspective of utilizing simple, indigenous approach to treat persisting Central Serous Chorioretinopathy (CSC). We would, however, like to seek a few clarifications.
The study mentions that cases diagnosed as CSC without any prior treatment were enrolled, but the duration was widely varied (ranged from 7 days to 2 years), leading to confusion whether the cases were of acute or chronic persistent CSC. Since long-standing CSC generally has limited visual prognosis,[2] it could be a confounding factor in the interpretation of results. Most patients with acute CSC resolve within 3 months;[3] we could not gather the reason for 60% of patients in the non-meditation group having persistent CSC at the end of 4 months.
More details are needed about the meditation protocol. What type of Pranayama was practiced? What exercises were included in Sukshma Vyayama? Did Shavasana consist of a session of guided meditation? What scientific rationale guided the sequence of the protocol? Under most systems of Yoga,[4] Sukshma Vyayama is performed first, followed by Shavasana and concluded with Pranayama. As any form of exercise in general and meditation and Yoga in particular, which are preferably done in the early morning or in the evening hours, why was it chosen between 10:30 and 11:30 am and what was the rationale? After the initial 2 weeks, did the patients continue their practice in similar settings and timings?
Regarding the meditation protocol, it is surprising how the effects of 4 weeks of practice for as little as an hour lasted for 4 months as it is well established that Yoga, Pranayama, and meditation do not produce instant results. They are effective when taken as a way of life and practiced consistently for long time.
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Conflicts of interest
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References
- 1.Nongrem G, Surve A, Venkatesh P, Sagar R, Yadav R, Chawla R, et al. Effect of short-term meditation training in central serous chorioretinopathy. Indian J Ophthalmol. 2021;69:3559–63. doi: 10.4103/ijo.IJO_3499_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Mrejen S, Balaratnasingam C, Kaden TR, Bottini A, Dansingani K, Bhavsar KV, et al. Long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy. Ophthalmology. 2019;126:576–88. doi: 10.1016/j.ophtha.2018.12.048. [DOI] [PubMed] [Google Scholar]
- 3.Ozkaya A, Alkin Z, Ozveren M, Yazici AT, Taskapili M, et al. The time of resolution and the rate of recurrence in acute central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy: A case-control study. Eye. 2016;30:1005–10. doi: 10.1038/eye.2016.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Iyengar B, et al. London: Harper; 2014. Light on Yoga. [Google Scholar]