Information
Editors
Central Serous Retinopathy
Essentials
- Central serous retinopathy (CSR, also known as central serous chorioretinopathy, CSCR) causes painless reduction of visual acuity due to accumulation of fluid underneath the retina.
- Typically a disease of the young and middle-aged, often associated with high stress exposure
- In the acute form of the disease, no treatment is usually necessary (good spontaneous healing tendency).
- The chronic form may cause permanent visual damage; laser treatment or pharmacotherapy should be considered.
- The patients should be treated by an ophthalmologist.
Incidence
- The fifth most common retinal disease
- Six times more common in men than in women
Risk factors
- Stress
- Imbalance of the sympathetic and parasympathetic nervous systems
- Hypertension
- Exogenous and endogenous glucocorticoids
- Heredity
Symptoms and findings
- Reduced visual acuity
- Distortion of text and lines (metamorphopsia)
- Change of refractive power towards hyperopia (need for increased plus power in glasses)
- Visual field defect
- Disturbances of colour vision
- Often unilateral but may be bilateral
- Distortion or blurring on Amsler chart
- Optical coherence tomography (OCT) of the ocular fundus showing fluid accumulation underneath the retina
Treatment
- Avoidance of stressors
- If the patient is on glucocorticoids, these should be withdrawn as far as possible.
- The acute form of the disease (less than 3 months) usually heals spontaneously without any treatment.
- The chronic form (more than 3 months) may cause permanent loss of vision.
- Photodynamic therapy should be considered: intravenously administered verteporfin activated in the ocular blood vessels by red light.