Central Serous Retinopathy

Abstract

Central Serous Retinopathy (CSR) is a condition of unknown cause in which fluid accumulates underneath the retina in the central macula.  This leads to distortion and blurring of vision.  Most patients with CSR are males in their third or fourth decade of life.

 

Full Article

Central Serous Retinopathy (CSR) is a condition of unknown cause in which fluid accumulates underneath the retina in the central macula.  This leads to distortion and blurring of vision.  Most patients with CSR are males in their third or fourth decade of life.  After the age of 50 or 55, the diagnosis is more difficult to make as there is a certain degree of overlap with age-related macular degeneration.

 

Stress or corticosteroid use may play a role in inciting or aggravating the condition.  Symptoms that a patient may experience include sudden onset of blurred or dim vision and decreased color vision.  Patients may also experience distortion of their vision; this is often manifested when reading as being unable to see all of the letters on the line clearly.  Patients may also experience seeing objects as smaller than normal.

 

Fluorescein angiography is a common test that can substantiate the diagnosis of CSR. in this test, an orange dye is injected into the patients vein and this dye is observed as it circulates through the ocular vasculature.  Ocular coherence tomography (OCT) is another test that is helpful.  This imaging modality can accurately detect fluid and swelling in the retina.

 

The typical patient with CSR does not require treatment.  Most episodes of this condition are self-limited and resolve within two to three months.  In some patients, the subretinal fluid persists for longer than this time period and in if this occurs treatment is recommended.  Thermal laser can be applied to the area of retinal pigment epithelium that is thought to play a role in fluid accumulation.  Usually this treatment is quite effective and can be very useful when the area of leakage is well away from the center of vision.  Other treatment modalities, like photodynamic therapy, can be used in certain situations.

 

Most patients will recover vision back to normal, however, some patients will report that their vision in the affected eye is not quite as good as compared to the vision in their normal eye even long after the fluid has resolved.  Approximately 25% of patients develop a recurrent episode.

 

Tenley Bower, MD, ARCT