Central Serous Chorioretinopathy (CSC) is a disorder characterized by the accumulation of serous fluid under the macula, which causes retinal detachment and impacts visual acuity.
망막 아래에는 맥락막이라는 혈관이 풍부한 조직이 있고, 그 사이에 망막색소상피(RPE)가 장벽 역할을 합니다.
When this barrier is compromised, fluid from the choroid leaks into the subretinal space, resulting in macular swelling.
The condition primarily affects men aged 30 to 50 and is frequently referred to as a 'stress-related eye disease' due to its strong correlation with psychological stress.
While it typically occurs unilaterally and often resolves spontaneously within weeks or months,
frequent recurrences or chronic cases may lead to permanent visual impairment.
Symptoms of Central Serous Chorioretinopathy
Because CSC affects the macular area, symptoms are typically characterized by disturbances in central vision.
The condition usually begins in one eye, and in some cases, symptoms may be so mild that the disease is discovered incidentally during a routine exam.
Patients experience a darkened or blurred area in the center of their visual field.
The center of the visual field appears hazy or blurred, resulting in a significant loss of clarity and sharpness.
Colors may appear faded or washed out due to decreased saturation.
Patients may also notice a distinct difference in color perception between the two eyes.
Straight lines appear curved, or the shapes of objects appear distorted.
When viewing with one eye, objects appear smaller than they actually are.
The difference in image size between
both eyes causes discomfort.
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
Since stress can be a major contributing factor,
it is important to manage stress and get adequate rest.
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.
When using steroid medications, it is important to follow your doctor's prescription and maintain hormonal balance.
In cases of frequent recurrence or chronicity, monitor the condition through regular ophthalmic examinations.
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.
Check out the blog below for more information on retinal diseases.
