Central Serous Retinopathy: Causes, Symptoms, and Treatment

Photo by Craig Adderley

Central serous retinopathy (CSR) is a condition that affects the retina, specifically the macula, causing vision disturbances. It is characterized by the accumulation of fluid under the retina, leading to blurred or distorted central vision. While typically not permanent, CSR can significantly impact daily activities and requires timely diagnosis and management to prevent long-term complications.

What Causes Central Serous Retinopathy?

CSR often occurs due to a leakage of fluid from the choroid (a layer of blood vessels beneath the retina) into the space under the retina. This leakage can be triggered by various factors:

• Stress: Psychological stress is a common trigger, as it may lead to the release of stress hormones that affect blood vessel permeability.
• Corticosteroids: Both systemic use and local administration of corticosteroids have been linked to CSR.
• Hypertension: Elevated blood pressure may contribute to the development or exacerbation of CSR.
• Type A Personality: Individuals with type A personalities, who are often competitive and time-urgent, may be more susceptible.

Photo by Mikhail Nilov

Symptoms of CSR

The hallmark symptom of CSR is central vision distortion, which may include:

• Blurriness or haziness in the central vision
• Diminished color perception
• Difficulty reading or performing tasks that require detailed vision
• A small blind spot in the central visual field

These symptoms typically manifest in one eye, but CSR can affect both eyes concurrently or sequentially.

Diagnosis and Treatment

Diagnosing CSR involves a comprehensive eye examination, which may include:

• Dilated Eye Exam: To examine the retina and assess the extent of fluid accumulation.
• Optical Coherence Tomography (OCT): This imaging technique provides detailed cross-sectional images of the retina, helping to visualize and quantify fluid under the retina.
• Fluorescein Angiography: A dye is injected into the bloodstream to highlight blood vessels in the retina, revealing any leakage points.

Treatment strategies aim to reduce fluid leakage and promote resolution of symptoms. Options include:

• Observation: In most cases, where symptoms are minimal and do not significantly impact vision, observation without intervention may be recommended.
• Laser Therapy: Focal laser treatment can be used to seal leaking blood vessels and reduce fluid accumulation.
• Medication: Anti-vascular endothelial growth factor (anti-VEGF) agents may be considered to reduce vascular permeability.

Photo by Riccardo

Most cases of CSR resolve spontaneously within a few months without causing permanent vision loss. Lifestyle modifications such as stress reduction techniques and management of systemic conditions like hypertension can help reduce the risk of this condition. If you are experiencing central vision distortion and blurred sight, it is important to seek prompt evaluation from an eye care professional.