Central Serous Retinopathy

Medically reviewed by Ann Marie Griff, OD on June 7, 2017Written by James Roland

Overview

Central serous retinopathy is an eye condition in which fluid builds up behind the retina and affects your vision. The retina is a thin, sensitive layer of tissue in the back of the eye. It converts light into neural signals that are sent to the brain. It helps you recognize the images you see.

The buildup of fluid can cause a partial detachment of the retina. Sometimes the condition, also known as central serous chorioretinopathy (CSC), corrects itself without treatment. But the sooner you recognize a change in your vision and have the problem diagnosed, the greater the odds of having a full recovery with no permanent vision loss.

Symptoms

CSC usually affects one eye, though you could conceivably have the condition in both eyes during your lifetime. The first symptom you’re likely to notice is blurry vision in the affected eye. Vision in that eye may also seem dim.

Other symptoms include:

  • darkness may exist in your central vision
  • straight lines may look crooked
  • objects may seem farther away than they really are
  • white objects may have a brownish or grayish tinge, making them appear dull

Depending on where the fluid buildup is located, you may not notice any change in vision. If the affected part of the retina doesn’t include the macula, you may continue to see things properly and with detail. The macula is the part of the retina responsible for distinguishing the finer details of an object you’re viewing.

Treatment

In many cases, the fluid collecting behind your retina will go away without any treatment. This can take a few months. During that time, an eye doctor can tell whether the fluid is draining away.

If the fluid doesn’t disappear on its own, several types of treatment are available.

For photodynamic therapy, your arm is injected with verteporfin, a drug that travels to the eye. A special cold laser is then focused on the part of the eye responsible for leaking fluid. The cold laser activates the verteporfin, which helps stop the leaking. It may also help prevent future leaks.

Thermal laser treatment can also help seal the tissue that’s leaking fluid behind the retina. The risk of scarring or other complications is greater with traditional thermal laser therapy than with photodynamic therapy.

Certain medications may also help, though you should consult with your eye doctor first. One is an anti-vascular endothelial growth factor medication (anti-VEGF). This drug helps prevent the growth of new blood vessels in the eye, a common cause of vision problems.

You should avoid taking corticosteroids and other drugs containing steroids. But make sure you talk with your doctor first. Suddenly stopping steroid therapy could have serious health complications.

Other lifestyle changes you should make to help treat or prevent CSC include:

  • avoiding caffeine, which can raise cortisol levels in the body
  • getting at least seven hours of sleep
  • reducing alcohol consumption
  • reducing stress through meditation, yoga, breathing techniques, and the avoidance of stressors in your everyday life

Causes and risk factors

Unlike many eye diseases that tend to strike when you’re older, CSC is more common among men in their 30s, 40s, and 50s. Women are also susceptible, but less so than men. Also, stress seems to be a major risk factor for CSC. This is because stress tends to produce higher levels of the stress hormone cortisol, which may cause eye inflammation and leakage behind the retina. People taking corticosteroids are also at higher risk.

The causes of CSC still are not well understood, but lowering your risk could be an extra incentive to reduce the stress in your life.

When to see your doctor

If you notice any change in your vision, you should make an appointment with your eye doctor. Don’t wait until your next appointment. Some eye conditions can worsen quickly and lead to permanent vision loss.

If you and your doctor take a watch-and-wait approach to treating your CSC, keep in mind that you should experience symptom improvements within a few months. If your symptoms worsen or only stay the same during that time, talk with your doctor about some form of laser therapy. Find out what options are safe and appropriate for you.

Outlook

Unfortunately, once you’ve had CSC, you’re more likely to have it again. The recurrence of this condition may warrant more aggressive treatment than the first time.

Once you’ve recovered, you should also talk with your doctor about whether it’s safe to take medications containing steroids. You may need to investigate different treatments for other health problems that you had been treating with steroids. If that’s not possible, you can at least know what symptoms to look out for if CSC develops again.

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