Central Serous Retinopathy (CSR) is a condition in which a small pool of fluid accumulates under the macula. A defect in the normally water tight layer beneath the retina allows the leakage of fluid which then collects under the retina. This forms a blister-like elevation which alters the function of the retina, and typically becomes noticeable when central vision is affected. CSR most commonly occurs in males in their 30’s to 50’s. The cause of CSR is unknown, although in some patients it is associated with corticosteroid use, including inhalers or skin creams. CSR has been commonly associated with stress or “type A” personalities.
Symptoms
The symptoms of an eye affected by CSR are blurred vision, distortion, or a central grey or dark spot. Vision can range from 20/20 to 20/200. Color vision may also be affected.
Diagnosis
The diagnosis of CSR is usually made by its characteristic clinical appearance. Fluorescein Angiography may be necessary to confirm the diagnosis. In Fluorescein Angiography, a dye is injected into an arm vein, and photos are taken as the dye passes through the retinal blood vessels. During this test the defect in the layer beneath the retina can be identified, as leakage of dye is typically seen. Optical Coherence Tomography (OCT) which shows a cross section of the retina, can also be useful in diagnosing CSR.
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Central Serous Retinopathy
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Fluorescein Angiography
of CSR |
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Treatment
In the majority of cases no treatment is required, and the condition resolves spontaneously within several months. In some cases, laser treatment to cauterize the leakage source can speed resolution of the fluid blister and improve vision. Behavior modification may be recommended if stress is thought to be a contributing factor. Photodynamic therapy, typically used in the treatment of Wet AMD, has been used in some individuals where CSR has persisted (see section on AMD).
Prognosis
The prognosis for CSR is generally excellent. Over 90% of patients regain 20/30 vision or better within 6 months. In some people, the condition will resolve leaving very subtle visual imperfections. In a small minority of patients, CSR may become a recurrent problem.
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