Central Serous Retinopathy
Central serous retinopathy or Central serous choroidopathy is characterized by localized detachment of neurosensory retina from the underlying layers at the macular are. It occurs due to defects in the Retinal Pigment Epithelial cells. The space between the detached neurosensory retina and the underlying layer is occupied by a clear serous fluid but sometimes can be turbid and yellowish in color. Causes and Risk FactorsThe main cause of this disease is unknown but they found multiple risk factors associated with it and these risk factors are:1- Type A personality. 2- Emotional Stress. 3- Gastro-esophageal Reflux. 4- Systemic Lupus Erythematous. 5- Tobacco use. 6- Alcohol use. 7- Systemic hypertension. 8- Organ Transplantation. 9- Corticosteroid which can be either oral, intravenous or through inhalation. Symptoms1- Unilateral Eye.Usually the condition is unilateral or occurs in one eye. 2- Blurred vision. That can be improved with plus lens because the retina is pushed forward and the eye becomes hyperopia or farsighted. 3- Metamorphopsia. Distorted lines or images. 4- Micropsia. Images look smaller than the actual size of it. 5- Dark adaptation. Impaired dark adaptation and delayed retinal recovery time to bright light. 6- Reduce color and contrast sensitivity. Diagnosis1- Slit Lamp Examination.Transparent retinal swelling in the posterior pole over the macular area. 2- Fluorescein Angiography. The diagnosis can be confirmed by this test in which a special pattern of dye leakage under the retina can be seen. This diagnostic test is very helpful in treatment because the sites of leakage can be treated with laser. 3- Optical Coherence Tomography (OCT). Shows the detached retina from the underlying layer. This diagnostic test can also be used in the follow up visits to determine the level of improvement. TreatmentsCentral Serous Retinopathy is a self limited disease in which the majority of patients have a spontaneous recovery within three to six months but in some patients it can last for more than 1 year especially in elderly.The first line of treatment is observation. If the patient shows no signs of improvement after 4 months, laser photocoagulation can be used to treat sites of fluorescein leakage. Other indications of laser treatments are permanent changes from Central serous retinopathy in the other eye, multiple recurrences or the patient requires faster recovery due to work. This treatment is done only for leakage sites that are away from the fovea. Laser Photocoagulation treatment helps to reduce the duration of the disease and helps to reduce the incidence of recurrence but has no effects on the final visual outcomes. For leakage sites at or near the fovea, the treatment can be done by Photodynamic Therapy. There is a new Laser Treatment with IRIDIX MicroPulse. For more information,
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