Central serous chorioretinopathy (CSCR) is a condition where fluid accumulates under the retina. The fluid often accumulates under the center of the macula, which is the center of vision. It leads to decreased visual acuity or distortion of images. Patients often report a central blur or a grey spot that is blocking their central vision. It presents most frequently in males age 20-50, but it can present in patients of any age or gender.
CSCR is often described as an idiopathic disease, which means that we don't know what causes it. However, in some patients, episodes of CSCR are triggered by the use of steroids. Oral steroids, topical steroids, inhaled steroids, or even steroids injected into joints can lead to the development of the disease. If a patient presents with CSCR, we always do a detailed medical history looking for any exposure to steroids. Stress is also thought to be an exacerbating factor for CSCR, so stress management techniques are emphasized as well.
CSCR is diagnosed by a combination of a dilated eye exam, OCT, and fluorescein angiography (a dye test where we inject dye in your vein and take pictures as it enters the circulation of the eye). The dilated exam reveals swelling of the macula and the OCT quantifies the amount of fluid, which provides detailed information about improvement for follow up examinations. The angiogram allows us to pinpoint the "hot spot", or the area of leakage that is creating the swelling if present, which can be a target for treatment. Some patients have a discrete leakage point that leads to the fluid accumulation whereas others have no such spot.
CSCR most often resolves without any treatment in 3-4 months. If it persists past 3-4 months, there are treatment options such as laser, PDT (a form of laser as well), and oral medications.
In 20-30% of patients, CSCR will recur in the same or the other eye. Therefore, after an episode of CSCR, we educate patients about avoiding oral steroids (if possible), as well as monitoring their vision at home for changes. Many patients report having no visual sequelae of an episode of CSCR, but some patients do report having blurred, dimmed, or distorted vision after the resolution of the fluid.
This blog is for informational purposes only and is not intended to be medical advice.
