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Central Serous Retinopathy

Central serous retinopathy is a medical condition where fluid builds up behind the retina in the eye. It can cause sudden or gradual vision loss as the central retina detaches. This central area is called the macula.

While medical intervention is not always needed to regain vision loss, a person experiencing any gradual or sudden vision loss needs to consult a doctor to ensure vision loss does not become permanent.

  • Early treatment is often key to making a full recovery.
  • Fast facts on central serous retinopathy:
  • In the early stages, a person is likely to notice blurry vision.
  • In some cases, a person may not experience any changes in vision.
  • The fluid that builds behind the eye may drain away on its own.

What is central serous retinopathy?

Central serous retinopathy is a build-up of fluid underneath the retina inside the eye.

The retina is responsible for translating light taken into the eye as images the brain can understand. The build-up of liquid can cause the retina to detach, and this can cause vision problems.

In some cases, no medical intervention is required, and the person will recover their vision after a short period.

However, people should see their doctor immediately if they start to notice changes in vision.

symptoms

Symptoms of central serous chorioretinopathy can include:

  • distorted, dimmed, or blurred central vision
  • a dark area in your central vision
  • straight lines may appear bent, crooked or irregular in your affected eye
  • objects may appear smaller or further away than they are
  • when you look at a white object, it may appear to have a brownish tinge or appear duller in color

Who is at risk for central serous chorioretinopathy?

Men in their 30s to 50s are more likely to develop central serous chorioretinopathy than women. Stress is a major risk factor. People under a lot of stress may be more likely to develop central serous chorioretinopathy.

Other risk factors for central serous chorioretinopathy are:

  • use of steroids (by mouth, through a vein or even inhaled)
  • Helicobacter pylori infection (a type of bacteria that can infect the stomach)
  • autoimmune disease (when the body attacks its own tissues)
  • sleep disturbances like insomnia (having trouble falling asleep or staying asleep) or sleep apnea (when breathing is interrupted during sleep)
  • type A behavior (aggressive and competitive behavior)
  • hypertension (high blood pressure)

causes

In most cases, CSR is idiopathic, which means no cause can be found to explain why it occurred. However, several possible risk factors have been identified. The condition seems
to occur more frequently in people:

  • with a Type A personality (people who are stressed and find it hard to relax)
  • who use steroid medication
  • during pregnancy
  • with Cushing syndrome.

When you’re under stress, your body releases a natural steroid into your bloodstream called cortisol which helps your body to cope.

Although cortisol is essential for your health, raised levels of cortisol can sometimes cause problems for your body. This can include immune suppression (reducing the body’s ability to fight infection) and increased fragility and permeability of the blood vessels.

Although cortisol is currently thought to be linked to CSR, it is not thought to be solely responsible for the condition and cannot explain all cases of CSR.

In most cases of CSR, the cause is unknown.

Treatment

In many cases, the fluid collecting behind your retina will go away without any treatment. This can take a few months. During that time, an eye doctor can tell whether the fluid is draining away.

If the fluid doesn’t disappear on its own, several types of treatment are available.

For photodynamic therapy, your arm is injected with verteporfin, a drug that travels to the eye. A special cold laser is then focused on the part of the eye responsible for leaking fluid. The cold laser activates the verteporfin, which helps stop the leaking. It may also help prevent future leaks.

Thermal laser treatment can also help seal the tissue that’s leaking fluid behind the retina. The risk of scarring or other complications is greater with traditional thermal laser therapy than with photodynamic therapy.

Certain medications may also help, though you should consult with your eye doctor first. One is an anti-vascular endothelial growth factor medication (anti-VEGF). This drug helps prevent the growth of new blood vessels in the eye, a common cause of vision problems.

You should avoid taking corticosteroids and other drugs containing steroids. But make sure you talk with your doctor first. Suddenly stopping steroid therapy could have serious health complications.

Other lifestyle changes you should make to help treat or prevent CSC include:

  • avoiding caffeine, which can raise cortisol levels in the body
  • getting at least seven hours of sleep
  • reducing alcohol consumption
  • reducing stress through meditation, yoga, breathing techniques, and the avoidance of stressors in your everyday life

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