Central serous chorioretinopathy


A rare eye disorder where fluid collects under the retina which affects vision. The condition usually resolves itself within 6 months though most people suffering lingering vision disturbances such as distortion, reduced sensitivity to contrast, impaired night vision and reduced color vision.


* Blurred vision * Distorted vision * Central bind spot * Reduced vision * Impaired night vision * Reduced color vision * Reduced contrast sensitivity


CSR is a fluid detachment of macula layers from their supporting tissue. This allows choroidal fluid to leak into the subretinal space. The buildup of fluid seems to occur because of small breaks in the retinal pigment epithelium.


The diagnosis usually starts with a dilated examination of the retina, followed with confirmation by fluorescein angiography. The angiography test will usually show one or more fluorescent spots with fluid leakage. In 10%-15% of the cases these will appear in a "classic" smoke stack shape. An Amsler grid could be useful in documenting the precise area of the visual field involved.


The prognosis for CSR is generally excellent. Over 90% of patients regain 20/30 vision or better within 6 months. Some visual abnormalities can remain even if visual acuity is measured at 20/20. Lasting problems can include decreased night vision, color discrimination problems, and some distortion. Long term complications can include subretinal neovascularization and pigment epitheliopathy.


There is no known effective treatment for the disease. Laser photocoagulation, which effectively burns the leak area shut, is sometimes suggested. In many cases the leak is very near the central macula, where photocoagulation would leave a blind spot. Additionally, a better long term outcome has not been demonstrated with photocoagulation. So more often than not the condition goes untreated. Transpupillary thermotherapy has been suggested as a lower-risk alternative to laser photocoagulation in cases where the leak is in the central macula. Any ongoing corticosteroid treatment should be stopped. Additionally, a new anti-microbial treatment will likely be recommended soon in light of recent findings regarding Helicobacter pylori. CSR sufferers usually find their own ways to manage the condition, which may include stress reduction and changes in nutrition