Central serous retinopathy (CSR), also known as central serous chorioretinopathy (CSC), is an eye condition which causes visual distortion, due to accumulation of fluid underneath the retina. More men, in their 20s to 50s, are affected with this condition than women.
To confirm the diagnosis of central serous retinopathy, a dilated examination of the retina followed by optical coherence tomography and fluorescein angiography is performed. The angiography test usually shows one or more leakage spots.
CSR is a result of fluid in the subretinal space and due to small breaks in the retinal pigment epithelium. The cause is unknown but stress appears to play an important role. Type A personalities, patients with elevated levels of corticosteroids due to either steroid administration (inhaled, topical or systemic) or Cushing syndrome are at an increased risk of developing CSR. Recently there is evidence that Helicobacter Pylori may also play a role.
The visual prognosis of CSR is generally excellent except in chronic, recurrent cases. Over 80-90% of patients regain vision within 6 months but it can take up to a year. Some patients do suffer permanently diminished visual acuity and 40-50% experience one or more recurrences.
Most patients with CSR don’t need any treatment. It is important to check any medications for corticosteroids, including nasal sprays and creams. Treatment is considered if the subretinal fluid does not resolve within 3-4 months. Laser photocoagulation may be considered if the leakage is a safe distance from the fovea. Photodynamic therapy (PDT) has shown promise as an effective treatment with minimal complications.
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