✅ Medically reviewed by Dr Sharon Heng
What is CSCR (or CSR)?
Central serous chorioretinopathy or central serous retinopathy (CSCR or CSR) affects the retina which is the light sensitive layer at the back of your eye which captures images and enables you to see.
The macula is the part of your retina that is critical for your vision. A layer of cells known as the retinal pigment epithelial cells (or RPE cells) have a pump action that helps to nourish the retina.
There is also a blood vessel layer beneath the retina is known as the choroid -- abnormality to the function of the RPE cells or the choroid may sometimes lead to a build-up of fluid between the outer layers of the retina. This condition is known as central serous chorioretinopathy (CSCR) or central serous retinopathy (CSR).
What are the Symptoms of CSCR?
If you already have CSCR and reading this article, you probably know the symptoms of the disease, which are as below:
Main symptoms include:
painless blurriness of central vision.
change in size of an object.
straight objects or lines seeming curved or distorted
difficulty in reading small prints.
Sometimes, even with resolution of the fluid, it may take a few weeks to months for full recovery of your vision. Some patients describe a lingering 'greying’ of parts of your visual fields, but this should eventually recover with time.
What Causes CSCR?
The exact factors that cause the development of CSCR related fluid have not yet been determined. The following are some known risk factors which are known to be associated with CSCR.
Steroid Use
Steroids are a known risk factor for the development of CSCR. These include steroids in different forms such as inhalers for asthma, nasal spray for hay fever, steroid cream for eczema and steroid tablets such as prednisolone.
Rarely, in a condition (known as Cushing syndrome), an over production of the body’s natural steroid hormone could lead to the development of CSCR. We usually ask that patients stop or consider alternative treatment to steroids where clinically possible.
Stress
A major stressful event is thought to trigger CSCR in some patients.
Type A Personality
There is a known association between some types of personality with occurrence of CSCR.
Genetic Risk
There are ongoing studies suggesting some patients may have changes in certain genes that can trigger CSCR when exposed to certain environmental factors.
What are the Complications of CSCR?
In the majority of patients, CSCR resolves without sequelae. However, a very small percentage of patients who have persistent or chronic CSCR, defined as over 6 months of period, may develop choroidal neovascular membrane (CNV) or loss of the outer retina layers (atrophy). CNV may be treated with antivegf injections, but macular atrophy does not have treatment and may result in permanent visual impairment.
When Should I See an Eye Specialist and Start Treatment?
When you develop a sudden onset of a painless blurred patch in your vision, you will need to see a medical retina eye specialist urgently for examination and imaging such an optical coherence tomography (OCT) scans. This allows prompt diagnosis, advice and subsequent monitoring can be initiated.
If your symptoms such as vision or distortion worsen over the next few months, please contact for an earlier review, if the fluid worsens or is non-resolving for more than 6 months, then the medical retina specialist will consider treatment following further investigations including fluorescein and indocyanine angiography.
These are also known as yellow and green dye tests which looks at retina and choroidal vasculature and identifies leaking spots and choroidal neovascular membrane (CNV). Treatment may include photodynamic therapy, laser (micropulse laser) or injections if there is CNV.
Do You Have Photodynamic Therapy or a Micropulse Laser?
Yes, Ms Heng’s settings have availability of ALL treatments for CSCR including photodynamic therapy, micropulse laser, and antivegf therapy. Depending on how advanced your disease is, where the leaking point is, she will advise on the pros and cons of individual therapy, precise and personalised to your disease.
Photodynamic therapy in general has shown superior outcomes as compared to lasers for CSCR due to its effect and action on the choroidal layers. Nonetheless, lasers may also provide very good results, but can only be performed on patients whose leaking points are away from the fovea as laser on the fovea may cause long-term damage.
Micropulse as compared to traditional lasers have a smaller range of damage and can be used safely in macular diseases.
Are There Oral Treatments?
Previously, in chronic cases, Eplerenone, a potassium-sparing diuretic and aldosterone-receptor antagonist that is primarily used to treat heart failure was used as a treatment. However, clinical trials performed show little evidence in improving vision of patients with CSCR.
If you have CSCR and would like further medical advise or treatment, please contact us to book an appointment to see Ms Heng.
Email: info@retina-eye.co.uk
Telephone: 07886 677351
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