Central Serous Retinopathy

Central serous retinopathy causes central vision loss secondary to fluid leaking under the center of the macula.

What is a Central Serous Retinopathy?

Moderate central vision loss in men (90% of these cases are men) aged 40 to 60 is sometimes caused by central serous retinopathy. Central serous retinopathy is caused by excessively leaky blood vessels in the choroid which is the layer of blood vessels under the retina. When these vessels become excessively leaky, fluid builds up in the choroid and some of that fluid can break through the barrier of the retinal pigment epithelium. The retinal pigment epithelium is a single layer of cells under that retina that are water tight. The fluid that breaks through the retinal pigment epithelium builds up under the retina forming a blister of fluid under the retina. This fluid blurs the vision in two ways. First, because the retina is elevated away from the retinal pigment epithelium by the fluid, it does not receive nutrients and oxygen as efficiently as it should and it doesn't work well. Second, because the retina is not where it should be, images become out of focus. Some people with central serous retinopathy will notice if they wear reading glasses, they can see better because the reading glasses can sometimes refocus the image on the elevated retina.

Cause of Central Serous Retinopathy

The animated image shows a classic smokestack on fluorescein angiography in a patient with acute central serous retinopathy. The white trace dye, fluorescein, does not leak out of the pigment epithelium under the retina. In patients with central serous retinopathy, there is leakage in the choroid of fluid that builds up and then pushes through the barrier layer under the retina, the retina pigment epithelium. That shows up as a leaky spot on the fluorescein angiogram. Because of the concentration gradient in the subretinal fluid, the fluorescein dye moves up from the leaky spot and forms a smokestack looking white are under the center of the macula.

Central Serous Retinopathy and Fundus Autofluorescence

There are several tests that can be done to establish the diagnosis of central serous retinopathy and to help guide management. Fundus autofluorescence - in the accompanying photograph, show the area of bright autofluorescence from the serous retinal detachment. The photoreceptor outer segments that accumulate in the serous retinal detachment autofluoresce and show up bright in the image. Also optical coherence tomography can show the choroidal thickening and the subretinal fluid. Fluorescein angiography and indocyaning green angiography will show which areas of the choroid are leaking and can help guide treatment.

Who develops Central Serous Retinopathy

Central serous retinopathy is associated with Type A personality. Ninety percent of cases occur in men. It is also sometimes seen in people taking steroids orally or by nasal spray. It can also be associated with pregnancy. Serous retinal detachments like those seen in central serous retinopathy can also seen in patients with severe high blood pressure, age related macular degeneration, and posterior uveitis.

The diagnosis of central serous retinopathy is usually established with optical coherence tomography, fluorescein angiography, and sometimes indocyanine green angiography.

Visual acuity usually returns to normal within about 6 months (sometimes sooner) in 95 percent of affected patients. The recurrence rate is 25 percent. If vision does not recover in a reasonably amount of time, hot laser, photodynamic therapy (cold laser) can be considered.

What is Chronic Central Serous Retinopathy

There are some patient who develop chronic central serous retinopathy. Those patients have subretinal fluid for more than 6 months. Sometimes subretinal fluid will persist for years. In those situations, the chronic subretinal fluid causes damage to the pigment epithelium and the overlying retina. Vision loss gradually develops. When a patient is treated for chronic subretinal fluid, even when the fluid goes away, there is often residual vision loss. Sometimes, with treatment, the vision loss can be stabilized or slowed. The accompanying image shows gutters where the chronic subretinal fluid tracks down due to gravity and causes damage that is visible with testing.

Central Serous Retinopathy Treatment

Very few patients with central serous retinopathy require treatment. 90% of patients improve without therapy. Sometimes, central serous retinopathy becomes chronic and causes vision loss that does not improve. Focal laser treatment to the leaking spot is usually effective in patients with CSR. More commonly, photodynamic laser with visudyne is used to treat CSR. Photodynamic laser is a very low power laser which is used to activate the visudyne. The visudyne is infused intravenously over 10 minutes then a 5 minute washout period is observed. Then 86 seconds of laser (low enegery) is used to activate the the drug and seal up the leaky areas in the choroid. This treatment is usually effective. It is likely safer than focal laser but does sometimes need to be repeated.

Central Serous Retinopathy NEWS

Below are current articles from a Google News Feed on Central Serous Retinopathy


Medscape

Central Serous Retinopathy Requires Individualized Approach
Medscape
WASHINGTON, DC — One treatment clearly does not fit all patients with central serous retinopathy (CSR). Determining which approach to try on which patient, and getting it paid for, is a challenge for eye care practitioners, researchers reported here ...


Global Optical Coherence Tomography Market Details by ...
Medgadget (blog)
Global Optical Coherence Tomography Market is expected to reach USD 2.4 billion by 2024 from USD 1.1 billion in 2016, at a CAGR of 11.7% in the forecast ...

and more »

Healio

Multi-Modal Imaging Including Optical Coherence Tomography Angiography in Patients With Posterior Multifocal ...
Healio
Since during the acute stage of central serous chorioretinopathy, both blood flow velocity and choroidal thickness are increased, it seems implausible that the reduced perfusion of choroid in APMPPE is due to a mechanical compression of the choroidal ...


Patients respond differently to central serous retinopathy treatment
Healio
WASHINGTON – A multitude of management options exist for central serous retinopathy, and “if the patient doesn't become better in 3 to 4 months, consider another option,” Roya Attar, OD, MBA, said here at Optometry's Meeting. Attar and Mohammed ...


Global Optical Coherence Tomography Market Analysis, Size, Regional Outlook, Competitive Strategies and Forecasts ...
MilTech
On the basis of application, the market is segmented into age-related macular degeneration, central serous retinopathy, diabetic retinopathy, macular edema, macular hole, macular pucker, vitreomacular traction, pre-retinal membranes, others.

and more »

Healio

Choriocapillaris Changes Imaged by OCT Angiography After Half-Dose Photodynamic Therapy for Chronic Central ...
Healio
Chronic central serous chorioretinopathy (CSC) is characterized by widespread alterations in the retinal pigment epithelium (RPE) as a result of persistent or recurrent serous retinal detachment (SRD) involving the macula. In eyes with CSC, the RPE may ...


ModernMedicine

Central serous retinopathy helped by NSAIDs
ModernMedicine
The vitreous, vessels, and periphery were unremarkable in each eye. Optical coherence tomography was ordered to determine the extent of the serous elevation in the left eye (see Figure 1). A diagnosis of central serous chorioretinopathy (CSC) was made.


Medscape

Central Serous Chorioretinopathy: Risk Factors Identified
Medscape
Hypertension, Helicobacter pylori infection, steroid use, sleep disturbances, autoimmune disease, psychopharmacologic medication use, and type A behavior are possible risk factors for central serous chorioretinopathy (CSC), according to a systematic ...


Photostimulation promising for central serous chorioretinopathy
ModernMedicine
Bucaramanga, Colombia—Central serous chorioretinopathy (CSC) is a fairly common retinal disorder that has been associated with “type A” personalities. The primary complaints upon presentation are usually limited to distorted vision, decreased color ...


ModernMedicine

New insights on 'pachychoroid spectrum' | Modern Retina
ModernMedicine
Central serous chorioretinopathy (CSC) is the diagnosis that usually comes to mind when retinal specialists see an eye with choroidal thickening. New insights ...

and more »

Irish Examiner

The flotsam and jetsam of the artistic life
Irish Examiner
I developed a condition called CSR [central serous retinopathy] and I lost the central vision in my right eye and some in my left eye. “Since then, the condition has stabilised, but it takes a while for your eyesight to adjust.” Bénédicte Coleman's ...


Nature.com

Finasteride is effective for the treatment of central serous chorioretinopathy
Nature.com
Central serous chorioretinopathy (CSC) is an acquired idiopathic disorder characterized by exudative detachment of the neurosensory retina and/or retinal pigment epithelium (RPE). It is more common in males than females, with an estimated incidence of ...


Half-dose verteporfin PDT increases visual acuity, reduces recurrence in central serous chorioretinopathy
Healio
COLORADO SPRINGS, Colo. — Photodynamic therapy with half-dose verteporfin significantly increased visual acuity in eyes with central serous chorioretinopathy compared with that in untreated controls, according to a study presented here. Furthermore ...


News-Medical.net

Quantel Medical wins FDA approval for innovative Easyret photocoagulator
News-Medical.net
The Easyret has a broad range of settings for treatment of pathologies such as diabetic retinopathy, macular edema and central serous chorioretinopathy. In addition to SingleSpot treatment mode, surgeons can select Multispot mode for a pattern of ...

and more »

Medscape

Optometry's Meeting by the American Optometric Association (AOA)
Medscape
Medscape Medical News, June 25, 2017. AOA Central Serous Retinopathy Requires Individualized Approach. Medscape Medical News, June 25, 2017. AOA Optometry Meeting Blends Learning, Advocacy, Entertainment. Medscape Medical News, June 19, ...


PDT should be considered for chronic central serous chorioretinopathy
Healio
WAILEA, Hawaii — Retina specialists should consider photodynamic therapy as an adjunctive treatment for chronic central serous chorioretinopathy, according to a study presented here. “PDT has been impressively good,” Rishi P. Singh, MD, said at Retina ...


How to manage solar retinopathy caused by viewing the eclipse
Healio
Sherman: Try to determine if the symptoms are related to viewing the eclipse. Typical symptoms are central graying or fuzziness of vision, blurred and/or distorted central vision or afterimages. Tearing is occasionally reported. Symptoms such as severe ...


Livemint

What your eyes can say about your health
Livemint
Blisters in the eyeballs are symptomatic of a condition called central serous retinopathy (CSR), typically caused by excessive mental or emotional stress, which can tax the body so much that the retina starts leaking blister-forming fluid. “Usually, in ...


Dynamic Chiropractic

Treating Central Serous Retinopathy: Adjunctive Nutritional Management
Dynamic Chiropractic
Visual loss due to central serous chorioretinopathy during corticosteroid treatment for giant cell arteritis. Clin Exper Ophthalmol, 2005;33(4):437-9. Fernández Hortelano A, Sádaba LM, Heras Mulero H, García Layana A. [Central serous chorioretinopathy ...


Motherboard

More Ways To Wreck Your Eyes Without Even Thinking About It
Motherboard
When this bleeding occurs behind the retina, central serous choroidopathy occurs. As fluid accumulates, pressure builds, with one possible outcome being retinal detachment. This is somewhat less common than retinopathy in diabetics, but it actually ...


Healio

Oral Rifampin for Central Serous Retinopathy: A Strategic Approach in Three Patients
Healio
The authors present three cases of chronic central serous retinopathy in which rifampin was used for the utility of its oral delivery in remote care and as an alternative to photodynamic therapy when intravenous access was not possible. In each of ...


Healio

Young woman reports blurry vision in one eye, spots, floaters
Healio
A 29-year-old African American female presented upon referral from a fellow optometrist for retinal evaluation. Her chief complaint was blurry vision in the left eye that had been consistently present for 2 weeks. She reported that her central vision ...


Daily Mail

ESPN reporter who was filmed belittling a tow truck employee last year now says the stress of it all has damaged her ...
Daily Mail
Central serous retinopathy (CSR) causes a blister-like swelling in layers of the retina. It happens when fluid is allowed to build up under the retina and eventually distort vision. CSR usually affects just one eye at a time. Stress is a major risk ...
NJ's Britt McHenry nearly spiraled out of control after angry viral rantNJ.com
ESPN's Britt McHenry: "I Blame Myself, but the Video Is Not Who I Am"MarieClaire.com

all 30 news articles »

NSAIDs Speed Central Serous Choroidopathy Recovery
Medscape
Central serous choroidopathy is characterized by spontaneous serous detachment of the neurosensory retina in the macular region, with or without retinal pigment epithelium detachment. Its cause is not known, but one theory suggests that increased ...

and more »

Canadian Occupational Safety

Call centre workers subject to harassment, abuse and threats
Canadian Occupational Safety
According to the Hang Up on Abuse website, one worker was so stressed on the job and experienced so much anxiety that they developed an eye condition called central serous retinopathy, which causes temporary visual impairment in one eye. And the ...


Reader's Digest

One Doctor Said I'd Go Blind Within 2 Weeks. But a Second Opinion Changed Everything.
Reader's Digest
After about ten minutes, he said, “Well, from what I hear, I think you have central serous retinopathy. It's induced by stress, and although it's rare—it occurs in only one in 100,000 females—it's more common in young people.” He found a handout ...


New iterations of laser trabeculoplasty emerging for glaucoma treatment
Healio
... technology whereby a duty cycle allows the tissue to cool off before the next laser application, making it a safe technology even for subfoveal treatment in macular edema due to diabetic retinopathy, vascular occlusions or central serous ...


AOP

Optical Express names its 'Eye Injury XI' football team
AOP
The multiple is highlighting that glaucoma, diplopia and central serous retinopathy may not be as common on the pitch as hamstring injuries, but they are among the vision problems that have forced top footballers onto the sidelines. Optical Express ...


Nature.com

The role of indocyanine green angiography imaging in further differential diagnosis of patients with nAMD who are ...
Nature.com
After ICGA imaging, 13 eyes (9.8%) were diagnosed as true nAMD, 74 eyes (56.1%) as polypoidal choroidal vasculopathy (PCV), 35 eyes (26.5%) as chronic central serous chorioretinopathy (CSC), 3 eyes (2.3%) as retinal angiomatous proliferation (RAP), ...


PetaPixel

My Hospital Eye or: How I Started to Love iPhoneography
PetaPixel
Professional photographers using their smartphones is just a fad, I thought, but it all came to me sooner than I expected. Some 3 weeks ago I was diagnosed with central serous retinopathy in my left eye and was hospitalised for 3 days. In the process ...

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