Central Serous Chorioretinopathy

What is central serous chorioretinopathy?

Central serous chorioretinopathy is a condition where fluid accumulates beneath the macula, causing the retina to detach and affecting vision.

Beneath the retina lies the choroid, a tissue rich in blood vessels, with the retinal pigment epithelium (RPE) acting as a barrier between them.

When this barrier function weakens, fluid from the choroid leaks beneath the retina, causing the macular area to swell.

 

It primarily affects men in their 30s to 50s and is closely linked to stress, hence it is also called a ‘stress-related eye disorder’.

It usually occurs in one eye and often improves naturally within weeks to months,

but frequent recurrence or chronicity can lead to permanent vision loss.

Central serous chorioretinopathy symptoms

Central serous chorioretinopathy typically affects the macular region, resulting in characteristic symptoms related to central vision.

It usually begins in one eye, and symptoms may be mild, sometimes leading to incidental discovery.

Central scotoma

The center of the object appears dark.

Central vision loss

The center of your vision appears hazy or blurry, resulting in reduced clarity.

Color Vision Changes

Colors may appear faded or less saturated.

You may also notice a difference in color perception between both eyes.

Metamorphopsia

Straight lines appear curved, or the shapes of objects appear distorted. 

Micropsia

When viewing with one eye, objects appear smaller than they actually are.

The difference in image size between

both eyes causes discomfort.

Reduced contrast sensitivity

In bright light it's fine, but under dim lighting

it becomes difficult to distinguish objects,

or letters appear blurry.

Causes of Central Serous Chorioretinopathy

Stress

Psychological stress increases cortisol

(stress hormone) secretion,

which is thought to heighten choroidal vascular permeability and cause fluid leakage.

Steroid use

All forms of steroids—oral, injectable, inhaled, nasal spray, topical ointments—are risk factors.

Steroids affect the choroidal blood vessels, promoting fluid leakage.

Sleep disorder

Sleep apnea, chronic sleep deprivation,

and irregular sleep patterns increase the risk.

Hypertension

High blood pressure affects the choroidal blood vessels,

increasing the risk of fluid leakage.

Hormonal imbalance

Hormonal imbalances caused by pregnancy, birth control pills, or steroid medications can lead to this condition,

which may lead to retinal detachment.

Other factors

Excessive caffeine intake, alcohol consumption, and the use of

immunosuppressants after organ transplantation

are also reported as risk factors.

Diagnosis/Examination of Central Serous Chorioretinopathy

Fundus examination

Optical Coherence Tomography (OCT)

Detailed examinations such as retinal angiography

Treatment of Central Serous Chorioretinopathy

Central serous chorioretinopathy often resolves spontaneously within 1 to 3 months without specific treatment.

If the condition does not resolve naturally, treatment will be initiated. Depending on the lesion, options include injections, laser therapy, or photodynamic therapy (PDT).

Prevention Guidelines for Central Serous Chorioretinopathy

Stress Management

Since stress can be a major contributing factor,

it is important to manage stress and get adequate rest.

Blood Pressure Management

Hypertension is one of the primary causes of central serous chorioretinopathy.

Regular blood pressure monitoring is essential, and medication should be used to control blood pressure when necessary.

Hormone Management

When using steroid medications, it is important to follow your doctor's prescription and maintain hormonal balance.

Regular checkup

In cases of frequent recurrence or chronicity, monitor the condition through regular ophthalmic examinations.

FAQ

In acute cases, symptoms typically improve spontaneously within 3 to 6 months. However, even with spontaneous improvement, subtle vision loss or color vision changes may persist, and the recurrence rate is high at 30 to 50%. If symptoms persist or recur repeatedly, active treatment is necessary.

Yes, steroids that are not administered systemically—such as topical ointments, nasal sprays, and asthma inhalers—can also cause or worsen central serous chorioretinopathy.

If you have this condition or a history of it, you should consult your doctor about using any form of steroids.

It usually occurs in one eye, but in about 40% of cases, it also affects the other eye or retinal pigment epithelial changes are observed. It is advisable to have both eyes checked regularly.

It commonly occurs in men in their 30s to 50s, and the prognosis is generally favorable. However, if it recurs repeatedly or becomes chronic, it can cause permanent vision loss.

Therefore, if symptoms appear, it is important to undergo an eye examination and receive appropriate treatment along with lifestyle modifications.

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