What is a Central Serous Retinopathy?
Moderate central vision loss in men (90% of these cases are men) aged 40 to 60 is sometimes caused by central serous retinopathy. Central serous retinopathy is caused by excessively leaky blood vessels in the choroid which is the layer of blood vessels under the retina. When these vessels become excessively leaky, fluid builds up in the choroid and some of that fluid can break through the barrier of the retinal pigment epithelium. The retinal pigment epithelium is a single layer of cells under that retina that are water tight. The fluid that breaks through the retinal pigment epithelium builds up under the retina forming a blister of fluid under the retina. This fluid blurs the vision in two ways. First, because the retina is elevated away from the retinal pigment epithelium by the fluid, it does not receive nutrients and oxygen as efficiently as it should and it doesn't work well. Second, because the retina is not where it should be, images become out of focus. Some people with central serous retinopathy will notice if they wear reading glasses, they can see better because the reading glasses can sometimes refocus the image on the elevated retina.
Cause of Central Serous Retinopathy
The animated image shows a classic smokestack on fluorescein angiography in a patient with acute central serous retinopathy. The white trace dye, fluorescein, does not leak out of the pigment epithelium under the retina. In patients with central serous retinopathy, there is leakage in the choroid of fluid that builds up and then pushes through the barrier layer under the retina, the retina pigment epithelium. That shows up as a leaky spot on the fluorescein angiogram. Because of the concentration gradient in the subretinal fluid, the fluorescein dye moves up from the leaky spot and forms a smokestack looking white are under the center of the macula.
Central Serous Retinopathy and Fundus Autofluorescence
There are several tests that can be done to establish the diagnosis of central serous retinopathy and to help guide management. Fundus autofluorescence - in the accompanying photograph, show the area of bright autofluorescence from the serous retinal detachment. The photoreceptor outer segments that accumulate in the serous retinal detachment autofluoresce and show up bright in the image. Also optical coherence tomography can show the choroidal thickening and the subretinal fluid. Fluorescein angiography and indocyaning green angiography will show which areas of the choroid are leaking and can help guide treatment.
Who develops Central Serous Retinopathy
Central serous retinopathy is associated with Type A personality. Ninety percent of cases occur in men. It is also sometimes seen in people taking steroids orally or by nasal spray. It can also be associated with pregnancy. Serous retinal detachments like those seen in central serous retinopathy can also seen in patients with severe high blood pressure, age related macular degeneration, and posterior uveitis.
The diagnosis of central serous retinopathy is usually established with optical coherence tomography, fluorescein angiography, and sometimes indocyanine green angiography.
Visual acuity usually returns to normal within about 6 months (sometimes sooner) in 95 percent of affected patients. The recurrence rate is 25 percent. If vision does not recover in a reasonably amount of time, hot laser, photodynamic therapy (cold laser) can be considered.
What is Chronic Central Serous Retinopathy
There are some patient who develop chronic central serous retinopathy. Those patients have subretinal fluid for more than 6 months. Sometimes subretinal fluid will persist for years. In those situations, the chronic subretinal fluid causes damage to the pigment epithelium and the overlying retina. Vision loss gradually develops. When a patient is treated for chronic subretinal fluid, even when the fluid goes away, there is often residual vision loss. Sometimes, with treatment, the vision loss can be stabilized or slowed. The accompanying image shows gutters where the chronic subretinal fluid tracks down due to gravity and causes damage that is visible with testing.
Central Serous Retinopathy Treatment
Very few patients with central serous retinopathy require treatment. 90% of patients improve without therapy. Sometimes, central serous retinopathy becomes chronic and causes vision loss that does not improve. Focal laser treatment to the leaking spot is usually effective in patients with CSR. More commonly, photodynamic laser with visudyne is used to treat CSR. Photodynamic laser is a very low power laser which is used to activate the visudyne. The visudyne is infused intravenously over 10 minutes then a 5 minute washout period is observed. Then 86 seconds of laser (low enegery) is used to activate the the drug and seal up the leaky areas in the choroid. This treatment is usually effective. It is likely safer than focal laser but does sometimes need to be repeated.
Central Serous Retinopathy NEWS
Below are current articles from a Google News Feed on Central Serous Retinopathy
New York Daily News
Trump-induced anxiety is so bad my eye started bleeding
New York Daily News
The ophthalmologist detected a blister on my retina, indicating Central Serous Retinopathy. A condition by and large thought to be psychosomatic, CSR is brought on by extensive worrying. Advertisement. But OMG, there was something else: My retina was ...
Easy on the Eyes: Protecting Eye Health Through Cancer Treatments
Specifically, agents designed to inhibit MEK protein, which plays an important role in the proliferation of malignant tumors, have been linked with central serous retinopathy (fluid buildup under the retina), retinal vein occlusion (small vein blockage ...
Central Serous Retinopathy Requires Individualized Approach
WASHINGTON, DC — One treatment clearly does not fit all patients with central serous retinopathy (CSR). Determining which approach to try on which patient, and getting it paid for, is a challenge for eye care practitioners, researchers reported here ...
Patients respond differently to central serous retinopathy treatment
WASHINGTON – A multitude of management options exist for central serous retinopathy, and “if the patient doesn't become better in 3 to 4 months, consider another option,” Roya Attar, OD, MBA, said here at Optometry's Meeting. Attar and Mohammed ...
Long-term outcomes in half-dose verteporfin photodynamic therapy for chronic central serous retinopathy
Dove Medical Press
Results: The average follow-up period for treatment was 19.3 months. Best-corrected visual acuity increased from logMAR means of 0.52 to 0.42 (p<0.05). Central retinal thickness and choroidal thickness also significantly decreased at last follow-up (p ...
Puasa Bisa Stabilkan Kesehatan Mata
Iwan menjelaskan, kelainan mata yang dipengaruhi olehfakor psikis atau pikiran, menyebabkan pembengkakan di daerah makula retina (CSCR : Central Serous Chorioretinopathy). Kemudian Iwan menjelaskan, kelainan mata terjadi karena proses-proses ...
Kaitan Puasa dengan Kesehatan Mata
Ia menjelaskan, kelainan mata yang dipengaruhi oleh faktor psikis atau pikiran, menyebabkan pembengkakan di daerah makula retina (CSCR: Central Serous ChorioRetinopathy). "CSCR artinya pembengkakan di daerah sentral makula retina mata pada ...
Characteristics of the Choriocapillaris Layer in Optical Coherence Tomography Angiography of Acute Central Serous ...
From the Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. The authors report no relevant financial disclosures. Address correspondence to ...
Safety, Tolerability Increases Post-Bevacizumab Injection in Intraocular Pressure
The research team looked at 42 patients who received an intravitreal injection of 2.5 mg/0.1 mL bevacizumab to treat central serous chorioretinopathy or diabetic macular edema. Changes in IOP, corneal endothelial cells and corneal thickness were ...
Questions remain about use of 'nondamaging' retinal laser therapies
In 2008, we published the first experience of a nonvisible subthreshold micropulse infrared diode laser treatment of central serous chorioretinopathy. We came to similar conclusions as Wood and colleagues, and micropulse laser is our current first-line ...
Challenges of Treating Irregular Astigmatism: Ophthalmology Times
A recent study discusses how to identify patients at risk for severe chronic central serous chorioretinopathy with epitheliopathy. A new device, worn like glasses, may improve vision in people considered legally blind. This weekly news roundup is ...
Array BioPharma Reports Financial Results For The Third Quarter of Fiscal 2018
PR Newswire (press release)
The incidence of selected any grade AEs of special interest, defined based on toxicities commonly associated with commercially available BRAF+MEK-inhibitor treatments for patients receiving the combination of encorafenib and binimetinib included: rash ...
Central Serous Chorioretinopathy: Risk Factors Identified
Hypertension, Helicobacter pylori infection, steroid use, sleep disturbances, autoimmune disease, psychopharmacologic medication use, and type A behavior are possible risk factors for central serous chorioretinopathy (CSC), according to a systematic ...
Friday's Hawaiian Eye 2018 speakers of the day named
Berdahl moderated a panel discussion titled “Redeeming the unhappy patient.” Sophie J. Bakri, MD, was awarded Speaker of the Day for Retina 2018. She presented “Update on proliferative vitreoretinopathy” and “What's new in central serous retinopathy.”.
OCT has important role in everyday optometry practice
I have become a big proponent of OCT in optometry practices. We as optometrists have the responsibility of being on the front lines of eye care, whether it be in a private or commercial setting, such as mine. In this capacity, we must embrace ...
Therapeutic benefit of melatonin in refractory central serous chorioretinopathy
Patients must have had a best corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity worse than 20/40, a central scotoma, or incapacitating metamorphopsia in the affected eye, and the ability to comply with the study protocol ...
Half-dose verteporfin PDT increases visual acuity, reduces recurrence in central serous chorioretinopathy
COLORADO SPRINGS, Colo. — Photodynamic therapy with half-dose verteporfin significantly increased visual acuity in eyes with central serous chorioretinopathy compared with that in untreated controls, according to a study presented here. Furthermore ...
Elderly man has central vision loss, lipofuscin accumulation
A 74-year-old Caucasian man presented with a chief complaint of bilateral and symmetric progressive decrease in central vision over the last 2 years. His self-reported ocular history was relevant for phacoemulsification with intraocular lens ...
VIDEO: Role of OCT angiography in central serous chorioretinopathy
At Retina 2016, Jay S. Duker, MD, discusses the use of OCT angiography in patients with central serous chorioretinopathy. At Retina 2016, Jay S. Duker, MD, discusses the use of OCT angiography in patients with central serous chorioretinopathy.
The relationship between mitotic rate and depth of invasion in biopsies of malignant melanoma
Dove Medical Press
In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy. Nooshin Bazzazi et al., Neuropsychiatric Disease ...
Choriocapillaris Changes Imaged by OCT Angiography After Half-Dose Photodynamic Therapy for Chronic Central ...
From Kansai Medical University, Hirakata City, Osaka, Japan (KF); and Nihon University, Chiyoda, Tokyo (AK, MY). Dr. Yuzawa reports grants, personal fees, and non-financial support from Novartis and Santen; grants and personal fees from Alcon Japan; ...
Heart failure drug could save the sight of patients with once-untreatable eye condition
Central serous chorio-retinopathy (CSCR), which is a type of macular degeneration, affects mainly people aged in their 30s and 40s and occurs when fluid gathers under the retina and damages the tissue. Now doctors believe that the drug eplerenone could ...
The flotsam and jetsam of the artistic life
I developed a condition called CSR [central serous retinopathy] and I lost the central vision in my right eye and some in my left eye. “Since then, the condition has stabilised, but it takes a while for your eyesight to adjust.” Bénédicte Coleman's ...
Treating Central Serous Retinopathy: Adjunctive Nutritional Management
Central serous chorioretinopathy in women. Ophthalmology, 1996;103(1):72-79. Garg SP, Dada T, Talwar D, Biswas NR. Endogenous cortisol profile in patients with central serous chorioretinopathy. Br J Ophthalmol, November 1997;81(11):962-4. Pizzimenti ...
PDT should be considered for chronic central serous chorioretinopathy
WAILEA, Hawaii — Retina specialists should consider photodynamic therapy as an adjunctive treatment for chronic central serous chorioretinopathy, according to a study presented here. “PDT has been impressively good,” Rishi P. Singh, MD, said at Retina ...
Researchers use heart drug to treat eye disease in groundbreaking study
Central serous chorio-retinopathy (CSCR), which is a type of macular degeneration, affects mainly people in their thirties and forties and occurs when fluid gathers under the retina and damages the tissue. There are 10 new cases diagnosed per 100,000 ...
How to manage solar retinopathy caused by viewing the eclipse
Sherman: Try to determine if the symptoms are related to viewing the eclipse. Typical symptoms are central graying or fuzziness of vision, blurred and/or distorted central vision or afterimages. Tearing is occasionally reported. Symptoms such as severe ...
Doctor who allowed patient with eye condition to continue driving bus suspended
After tests, he was found to have a condition called central serous chorioretinopathy, which occurs when layers of the retina separate due to collection of fluid between them. He underwent focal laser treatment and was given 15 days' medical leave.
AMD patient with blurry vision
A 71-year-old Hispanic male presented to the eye clinic with complaints of blurry vision in both eyes of 4 months duration. The patient had been followed in the clinic for dry age-related macular degeneration for numerous years. He was given a home ...
Luxturna pricing tops January retina news
News of Spark Therapeutics' breakthrough gene therapy for inherited blindness being priced at $850,000 was the most-read retina-related article on Healio.com/OSN in January. The company's licensing agreement with Novartis for the treatment outside of ...