CENTRAL SEROUS RETINOPATHY

What is Central Serous Retinopathy?
Central Serous Retinopathy (CSR) also know as Idiopathic Central Serous Chorioretinopathy, is a condition in which there is a collection of fluid beneath the center (the macula) of the retina. The retina is the nerve tissue that lines the back wall of the eye. Much like the film in a camera, the retina is sensitive to light. It transforms light energy to nerve stimuli, and “sends a picture” through the optic nerve to the brain. The macula is the part of the retina that provides for sharp, clear color vision. Our ability to read and to see fine detail depends upon the health of the macula. The collection of fluid beneath the macula can interfere with its function.

What causes this condition?
The definite cause is unknown, but the onset of symptoms may occur at a time of unusual emotional stress. The condition typically affects healthy young and middle-aged males, ages 20-45.

What are some of the symptoms?
Visual acuity is often only moderately decreased. Some of the more common symptoms include:
Distortion of central vision
Objects appearing smaller that they are
A “blind spot” in central vision
Colors not appearing as vivid and difficulty distinguishing between colors

DIAGNOSIS
How is this condition diagnosed?
Upon clinical examination, the physician can often see a well-defined, round or oval shallow elevation of the retina in the macula. Fluorescein Angiography may be performed to confirm the diagnosis and assess for leakage for the affected area.
Fluorescein Angiography is a test in which a water soluble dye is injected into a vein in the arm. The dye quickly passes through the circulation to the eye and serial photographs are taken to examine the retinal circulation.

TREATMENT
What is the treatment?
In most cases, time will be given for spontaneous resolution of the fluid before considering treatment with laser. The chance of spontaneous resolution and return of vision is excellent. The amount of time allowed depends upon whether this is the first occurrence of this problem, and upon the size and location of the leakage. When laser treatment is used, a small application is usually sufficient to cause resolution. The laser is a bright, highly focused beam of light which can seal the leaks and help with reabosrption of the fluid.

How long does it take for the vison to improve?
Visual improvement can occur for at least six months after the resolution of the fluid. However, many patients will still have a mild permanent defect such as a loss of color sensitivity, a small “blind spot” or some mild form of distortion.

Could there be a recurrence of this condition?
Yes. It is possible for a recurrence to occur in the same eye. There is about a 40% chance that this could happen. There is also a possibility of the other eye being affected at another time. It is important to check the vision in each eye individually to monitor for any changes. Any such changes should be reported to your physician.

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