Central serous retinopathy

OCT of Cystoid macular edema

OCT of Central serous retinopathy

Central serous retinopathy (CSR), also known 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 allows a person to have 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.

The definite cause of this condition is unknown, but the onset of symptoms may occur in a patient at a time of unusual emotional stress. CSR typically affects healthy young and middle-aged males between ages 20 and 45 years of age.

With CSR, clear vision (called visual acuity) is often only moderately decreased. Some of the more common symptoms of CSR include:

  • Distortion of central vision
  • Objects appearing smaller than they are
  • A “blind spot” in central vision
  • Colors not appearing as vivid, and difficulty distinguishing between colors

During a clinical examination, the physician can often see a well-defined, round or oval shallow elevation of the retina in the macula, which points to a diagnosis of CSR. 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.

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.

The laser is a bright, highly focused beam of light that can seal the leaks and help with reabsorption of the fluid. When laser treatment is used to treat CSR, a small application is usually sufficient to successfully improve or correct the problem.

Visual improvement can be experienced for at least six months after the reabsorption 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.

There is about a 40% chance that this condition will reoccur in the same eye. 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.