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Newtown Square

Central Serous Chorioretinopathy

Central Serous ChorioretinopathyCentral serous chorioretinopathy (CSCR), also known as ​​central serous retinopathy, is a condition that causes fluid to build up underneath the macula, the center of the retina. Fluid leaks from a layer of blood vessels that run beneath the retina called the choroid.

CSCR is often a chronic disease. It may recur in 20 to 30 percent of patients, and some degree of permanent visual loss is more likely in recurrent or prolonged cases.

Central Serous Chorioretinopathy Symptoms

Central serous chorioretinopathy symptoms can include:

  • Distorted or blurred central vision
  • A gray or blind spot in the central vision
  • Straight lines may appear bent
  • Objects may appear distorted or miniaturized
  • Colors may appear washed out

Causes and Associations

The exact cause of CSCR remains unknown, but associations can include:

  • Corticosteroid use (oral, topical, inhaled or injected)
  • Stress
  • Pregnancy
  • Cushing Syndrome
  • High blood pressure
  • Organ transplantation
  • Lupus

Central serous chorioretinopathy is more common in men, primarily between the ages of 25 to 50 years. Those with a history of CSCR should avoid steroid medications if possible.

Testing

A comprehensive eye examination is important to assess CSCR, including vision testing, eye drops to dilate the pupils, and a complete examination of the front and back of the eye. It is best if a driver accompanies the patient during their eye exam, as pupillary dilation may create near-vision blurring.

People with CSCR may undergo several tests to evaluate their condition, including:

  • Optical Coherence Tomography (OCT): OCT is valuable in the immediate and long-term management of CSCR across all stages, including diagnosis, monitoring, treatment planning, and response to the treatment. Click the link to learn more.
  • Fluorescein Angiography (FA): FA helps diagnose and manage CSCR by injecting a dye into the bloodstream, then taking images of the retina to identify areas of abnormal blood vessel activity and fluid accumulation. Click the link to learn more.

Central Serous Chorioretinopathy Treatment

In most cases, the fluid under the retina resolves spontaneously over several months. Patients are usually followed without treatment, but treatment may be recommended for those who maintain subretinal fluid after a few months. The final visual outcome is usually good, though not always perfect, due to permanent damage to the retinal tissue.

Treatment selection is based on the severity of the condition and the individual patient and may include the following:

Laser Photocoagulation

Laser photocoagulation is performed in the office setting. A laser delivers a split-second burst of intense light energy to treat leaky retinal blood vessels or promote the shrinkage of abnormal blood vessels. If there is too much bleeding in the retina, laser photocoagulation cannot be performed.

Photodynamic Therapy

Photodynamic therapy (PDT) is a two-step procedure that can be performed in the doctor’s office. A light-activated drug is injected into the patient’s arm and activated in the eye with a non-thermal laser. Treatment may need to be repeated over the course of one to two years in order to promote vision stabilization.

Intravitreal Injections

Intravitreal injections are used to treat many retinal conditions. With this treatment, anti-vascular endothelial growth factor (VEGF) inhibitors or steroids are injected directly into the eye. This procedure is performed in the office and requires only a local anesthetic. Intravitreal injections may be administered as frequently as once a month (depending on the condition being treated) in order to maintain eye health and optimize vision.

If you have any signs or symptoms of CSCR, contact us today to meet with a Mid Atlantic Retina specialist. Our team can work with you to protect your vision and minimize your complications.