Central serous retinopathy

Central serous retinopathy (CSR) is a fairly common retinal disorder where the patient notices a fairly sudden onset of blurred vision in one eye associated with a central blank spot, distortion of vision, impaired dark adaptation, and a change of focus. Sometimes the other eye can be involved in a subsequent episode.

It is typically a disease of young or middle-aged adults that gets better by itself.

It seems to be more common in patients who have high blood pressure, are taking cortisone medicines, or sympathomimetic medicines such as nose decongestants (including sprays). Stress has been implicated too.

On examination, there is usually a unilateral, localised accumulation of fluid under the retina. Special tests often show there is a bilateral abnormality present.

OCT/ANGIOGRAPHY

Although in most cases the diagnosis is made by office examination, an OCT and/or Angiography is helpful in providing a definitive diagnosis and in planning treatment.

EXPECTATIONS

About 80% of eyes with CSR undergo spontaneous resolution of sub retinal fluid and a return to normal or near normal vision within 1-6 months. The remaining 20% last longer than 6 months, but most resolve within 12 months. Even if vision as tested on a chart returns to normal, some degree of subjective visual impairment can persist.

MANAGEMENT

Diamox tablets help to achieve a faster result, but the final visual outcome is no better.

Laser photocoagulation to the site of leakage in the retina often results in a speedier resolution of the fluid leak. However, it makes no difference to the final visual outcome.