Central Serous Retinopathy
Central Serous Retinopathy (CSR), also known as Central Serous Choroidopathy, is a disease that affects the retina and the layer underneath the retina, called the choroid. The retina normally sits on a layer of cells, called the retinal pigment epithelium (RPE), that acts as a barrier from the layer of blood vessels called the choroid.
In CSR, the choroidal vessels thicken and the RPE becomes permeable to fluid which leaks underneath the retina causing a blister-like collection (also known as serous detachment). Patients may notice blurry vision, a circular after-image, change in colors or distortion in vision when this occurs.
Risk Factors for Central Serous Retinopathy
- Typically affects men in their 30s to 50s
- Seems to be related to high-stress levels or “type A” personality. It is thought that higher natural circulating stress hormones can cause the RPE and choroid to leak fluid underneath the retina.
- Exogenous steroids (such as prednisone, dexamethasone) taken by mouth (but also possibly inhaled or topically applied) can worsen swelling in this disease
- Other risk factors include caffeine and high blood pressure
Diagnosis and Treatment
CSR is diagnosed after a complete eye exam is performed including OCT, fluorescein angiogram and photos. It is a disease that affects both eyes, but often only one is symptomatic since fluid can be present in the other eye away from the central vision and therefore go unnoticed.
Most cases of CSR improve spontaneously. In addition, removing unnecessary steroid medications can also improve the disease.
If the fluid does not improve, then treatments are available that include injections of a medicine, photodynamic therapy, oral medications or laser. The disease is chronic and difficult to control in a minority of patients. Also a minority of patients will develop secondary abnormal blood vessels in the retina (choroidal neovascularization) that require treatment similar to that of exudative age-related macular degeneration.
For Further Information
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Images on this page courtesy of The Retina Research Fund.