Central serous chorioretinopathy

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Central serous chorioretinopathy
Central serous chorioretinopathy
Synonyms	Central serous retinopathy, CSR
Pronounce	N/A
Specialty	N/A
Symptoms	Visual impairment, metamorphopsia, scotoma
Complications	Permanent vision loss
Onset	Typically between ages 20 and 50
Duration	Weeks to months, can be recurrent
Types	N/A
Causes	Unknown, associated with stress, corticosteroid use
Risks	Type A personality, hypertension, sleep apnea
Diagnosis	Ophthalmoscopy, optical coherence tomography, fluorescein angiography
Differential diagnosis	Age-related macular degeneration, retinal detachment, macular edema
Prevention	N/A
Treatment	Observation, photodynamic therapy, laser photocoagulation
Medication	N/A
Prognosis	Generally good, but can lead to chronic vision problems
Frequency	1 in 10,000 annually
Deaths	N/A

Central Serous Chorioretinopathy

Central serous retinopathy

Central serous chorioretinopathy (CSCR) is an eye disease characterized by the accumulation of fluid under the retina, leading to a localized detachment of the retinal pigment epithelium (RPE). This condition primarily affects the macula, the central part of the retina responsible for sharp, detailed vision. CSCR is most commonly seen in young to middle-aged adults and is more prevalent in males than females.

Pathophysiology

The exact cause of CSCR is not fully understood, but it is believed to involve a dysfunction of the choroid, the vascular layer of the eye that supplies blood to the retina. This dysfunction leads to increased permeability and leakage of fluid through the RPE, resulting in the accumulation of subretinal fluid. Factors such as stress, corticosteroid use, and hypertension have been associated with the development of CSCR.

Clinical Presentation

Patients with CSCR typically present with sudden onset of blurred or distorted vision, often described as a "gray spot" in the central vision. Other symptoms may include micropsia (objects appearing smaller than they are), metamorphopsia (distorted vision), and reduced contrast sensitivity. The condition is usually unilateral, affecting one eye, but can occur bilaterally in some cases.

Diagnosis

Central serous chorioretinopathy

Diagnosis of CSCR is primarily based on clinical examination and imaging studies. Optical coherence tomography (OCT) is a non-invasive imaging technique that provides cross-sectional images of the retina, allowing for the visualization of subretinal fluid and RPE detachment. Fluorescein angiography and indocyanine green angiography (ICG) can also be used to assess choroidal circulation and identify areas of leakage.

Management

In many cases, CSCR resolves spontaneously without treatment within a few months. However, in persistent or recurrent cases, intervention may be necessary. Treatment options include laser photocoagulation, photodynamic therapy, and anti-VEGF injections. Lifestyle modifications, such as stress reduction and avoiding corticosteroids, may also be recommended.

Prognosis

The prognosis for CSCR is generally good, with most patients experiencing a full recovery of vision. However, some individuals may have residual visual disturbances or experience recurrent episodes. Chronic CSCR can lead to permanent vision loss due to damage to the RPE and photoreceptors.

See also

• Retina
• Macula
• Retinal detachment
• Choroid

ICG vs LDH in CSCR

See Also

• Optical coherence tomography
• Fluorescein angiography
• Indocyanine green angiography