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Central Serous Retinopathy

Dr Ben Wild

Overview

The retina is located at the back surface of the inside of the eye. Its main function is to detect and transmit the sensation of light to the brain for interpretation. Clinically, the macula refers to the part of the retina that represents the finely detailed central vision.

Healthy retina

A frontal view of a healthy eye fundus (back of the eye) where the macula represents the dark circle.


Central serous retinopathy (CSR) is still a poorly understood condition without any known cause but has been highly associated with high levels of cortisol which occurs during times of high stress. It represents a condition where a large area of swelling occurs under the macula of one eye. It is extremely rare for it to occur in both eyes. This swelling can change color perception, can cause a noticeable spot in the central vision, can decrease vision and distort vision and can sometimes make someone more farsighted.

Retina with central serous retinopathy

A frontal view of an eye with swelling caused by CSR.

Signs and Symptoms

Signs

Area of swelling underneath the retina sometimes only visible with specialized machinery.


Symptoms

Unilateral (one eye) blurred vision, unilateral change in color vision, distorted vision.

Causes and Risk Factors

Causes

Unknown.


Risk Factors

Use of corticosteroids, type A personality, high stress, Cushing’s syndrome, pregnancy, sleep apnea, helicobacter pylori infection.

Prevention and Treatment

Prevention

There are no known preventative measures other than living a low stress lifestyle.


Treatments

· In most cases, no treatment is required.

· Steroid eye injection.

· Laser photodynamic therapy.

· Anti-VEGF eye injection.

· Aspirin has shown mixed results.

· Beta-blockers.

Prognosis

80% of the time, CSR spontaneously resolves within 3-6 months without treatment. In other cases, treatment is needed for resolution. CSR can reoccur in up to 50% of patients. If CSR remains unresolved after 12 months, permanent damage can occur.

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