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Central Serous Retinopathy

What is Central Serous Retinopathy?

Central serous chorioretinopathy, commonly referred to as CSR, is a condition in which fluid accumulates under the retina, causing a serous (fluid-filled) detachment and vision loss.

CSC most often occurs in young and middle-aged adults. For unknown reasons, men develop this condition more commonly than women. Vision loss is usually temporary but sometimes can become chronic or recur.

What are the symptoms of CSR?

Blurry central vision, which often occurs in one eye, is the most common symptom that patients experience. Careful examination often reveals some involvement in the other eye as well which is often asymptomatic.

Depending on the location and amount of sub-retinal fluid, CSR can show no symptoms, especially if the affected areas fall outside of the macula—the part of the retina used to distinguish fine detail for activities like reading and recognising faces.

What are the causes of CSR?

 

The causes of CSR are not fully understood. It is thought that any systemic exposure to a corticosteroid drug can bring about or worsen CSR. Corticosteroids are found in allergy nose sprays and anti-inflammatory skin creams available over the counter, and are often prescribed to treat a variety of medical conditions.

An association has also been made between CSR and patients with stress. It is possible that the body produces natural corticosteroids in times of stress that may trigger CSR in an individual prone to this condition. 

Half of patients with CSR have some genetic link and often careful question will identify another affected family member. 

Other risk factors include high blood pressure, pregnancy and other drugs including stimulants, decongestants, erectile dysfunction medications, and some anti-cancer agents may trigger CSR.

What is the treatment for CSR?

CSR is typically a self-limiting disease, and visual recovery usually occurs within a few weeks to months without treatment.

Patients who are taking corticosteroids of any kind should discontinue their use if possible, but only after checking with their prescribing physician to ensure it is safe to stop. 

Several therapies have been used to treat chronic CSR, including thermal laser treatments, oral medications, and eye injections. A “cold laser,” called photodynamic therapy, is also effective and often used to focally treat the source of fluid leakage under the retina in chronic CSR.

With photodynamic therapy, a drug called verteporfin is injected into the arm, where it travels to the eye. The verteporfin is activated by shining a special cold laser on the source of leakage in chronic CSR. It may also prevent future recurrences in some eyes.

Depending on the severity and timeline of your symptoms, your doctor will choose the best treatment option, which often begins with a trial of observation. Early detection of CSR is very helpful, and most eyes with CSR can be treated successfully to avoid permanent vision loss.