Central Serous Chorioretinopathy

Central serous chorioretinopathy (CSCR) is blister-like elevated areas in the macular area. It is characterized by an accumulation of transparent fluid at the posterior pole of the fundus, causing a circumscribed area of retinal detachment at the posterior pole. This elevation results is reduction and/or distortion of vision that usually recovers in a few months, but can reoccur. CSCR usually affects more men between the ages of 25 and 50 than women. Patients generally present with blurred central vision, wavy or distorted vision, or a central blind spot. Occasionally, the patient’s central vision loss is permanent, but it usually clears spontaneously in 3 months. Amsler grid assessment should be performed daily by the patient with reporting of any changes in vision immediately.

The cause of CSCR is still not completely understood. It is plausible to assume that at the basis of the disease there is more diffuse disfunction of the retinal pigment epithelium cells, the choroid or both. There may be an association with steroid therapy for other systemic reasons.

Other conditions that are included in the differential diagnosis are presumed ocular histoplasmosis syndrome, idiopathic choroidal neovascular vessels, Harada’s disease, posterior scleritis, posterior sympathetic uveitis, idiopathic uveal effusion syndrome, benign reactive lymphoid hyperplasia of the choroid.

Treatment is generally not necessary, but if the patient has persistent leakage, laser treatment may be required to seal the leak and help improve vision. Direct laser treatment of the leakage point not only shortens the acute phase of the disease, but also lowers the recurrence rate to one fifth of what would be expected without active treatment.