Central serous chorioretinopathy (CSCR) is a condition where fluid builds up under the retina. This can lead to visual distortions. The fluid leakage comes from a layer of tissue under the retina called the choroid. The layer of cells between retina and choroid is called the retinal pigment epithelium (RPE). When RPE does not work as it should, fluid builds up under the retina or the RPE, resulting in a small detachment and visual distortion. CSCR usually affects just one eye at a time, but both eyes can be affected at the same time.

Fluorescein angiogram showing increasing hyperfluorescence or leakage of dye consistent with CSCR.

What are Symptoms of CSCR?

  • Distorted, dimmed, or blurred central vision
  • A dark area in your central vision
  • Straight lines may appear bent 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

What are the Risk Factors for CSCR?

  • Men in their 30s to 50s
  • Stress
  • Exposure to steroids (by various methods such as injections, oral intake, inhalation, etc)
  • 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 personality (ex. competitive behavior)
  • Hypertension (high blood pressure)

How is CSCR Diagnosed?

Your Retina Specialist will perform diagnostic tests including fluorescein angiography which uses fluorescein dye traveling throughout blood vessels to show characteristic leakage of the dye in the affected area, and optical coherence tomography (OCT) which shows the presence of any fluid or scarring under the retina or the RPE.

OCT of a patient with CSCR showing subretinal fluid.

How is CSCR Treated?

Most cases of central serous chorioretinopathy clear up in one or two months without any treatment, although the underlying etiology needs to be addressed when applicable. During this time, your retina specialist will monitor the fluid for resolution.

Sometimes there is severe vision loss or the leakage does not go away. In these cases, treatment options such as laser treatment, photodynamic therapy, or at times oral medications may be used. These treatments can seal the leak and restore vision.

Most people with CSCR regain good vision. But vision may not be as good as it was before the condition. About half of patients who have had central serous chorioretinopathy will have recurrences. Given long-term fluid accumulation can lead to permanent vision loss, it’s important to have routine follow-up evaluations by your retina specialist to ensure no treatment is indicated.

Source: American Academy of Ophthalmology