CSP-2503

Central Serous Chorioretinopathy (CSC)

Diagram of the eye showing the location of the retina and choroid.

Central Serous Chorioretinopathy (CSC) is a medical condition affecting the eye, specifically the retina and the underlying choroid. It is characterized by the accumulation of fluid under the retina, leading to a serous detachment of the neurosensory retina. This condition can cause visual disturbances, including blurred vision and a central scotoma.

Pathophysiology

CSC is believed to result from a dysfunction in the retinal pigment epithelium (RPE) and the choroidal circulation. The exact mechanism is not fully understood, but it is thought that increased permeability of the choroidal vessels leads to leakage of fluid into the subretinal space. This fluid accumulation causes a detachment of the retina, affecting visual acuity.

Risk Factors

Several risk factors have been associated with CSC, including:

• Stress: Psychological stress is a significant risk factor, possibly due to increased levels of cortisol.
• Corticosteroid use: Both systemic and topical corticosteroids have been linked to the development of CSC.
• Hypertension: High blood pressure may contribute to choroidal vascular changes.
• Sleep apnea: This condition has been associated with CSC, possibly due to vascular dysregulation.

Symptoms

Patients with CSC typically present with:

• Blurred or distorted vision (metamorphopsia)
• A central dark spot (scotoma) in the visual field
• Reduced contrast sensitivity
• Micropsia, where objects appear smaller than they are

Diagnosis

Cross-sectional view of the retina showing fluid accumulation.

Diagnosis of CSC is primarily clinical, supported by imaging studies such as:

• Optical coherence tomography (OCT): This imaging technique provides detailed cross-sectional images of the retina, showing the presence of subretinal fluid.
• Fluorescein angiography: This test can highlight areas of leakage from the choroidal circulation.

Treatment

The management of CSC often involves observation, as many cases resolve spontaneously. However, treatment options may include:

• Photodynamic therapy: This involves the use of a photosensitizing agent and laser to reduce choroidal leakage.
• Anti-VEGF therapy: These injections can help reduce fluid accumulation.
• Lifestyle modifications: Reducing stress and discontinuing corticosteroid use may be beneficial.

Prognosis

The prognosis for CSC is generally good, with many patients experiencing spontaneous resolution of symptoms. However, some individuals may have recurrent episodes or develop chronic CSC, leading to permanent visual impairment.

Related Pages

• Retinal detachment
• Macular degeneration
• Choroid
• Retina