CENTRAL SEROUS RETINOPATHY

Introduction:

  • This condition leads to the build up of fluid at the macula.
  • It typically affects young males.  Males outnumber females by a ratio of 10:1.  In females, pregnancy is a risk factor for this occurring.

 

Symptoms:

(1)  Blurry vision

(2)  “Patch” in central vision:

  • This can be in various shapes reflecting shape of the accumulated fluid at the macula.

(3)  Distortion:  Lines and edges appear wavy

(4)  Reduced Colour Vision

(5)  Changes In Image Size:

  • Images may be larger or smaller in the affected eye

 

Precipitating Factors:

(1)  Ingested Corticosteroids

These are “medical steroids” and are used in a lot of conditions.  They are not like “anabolic steroids” which are used to build muscle.  Common examples are Prednisone, Hydrocortisone, Methylprednisolone, Beclomethasone.  Any form of intake can cause this including oral medication, inhaled sprays and puffers.  E.g. Asthma, skin creams and even joint injections.  Please discuss your medications with your G.P.

(2)  Stress

Often patients are “highly strung” with “Type A” personalities. It is thought that stress stimulates the release of corticosteroid like hormones by the body’s adrenal glands.

(3)  Racial Group

It is felt that individuals of Asian origin are at risk of a more severe form of the disease.

 

Investigations:

(1)  Angiography:

There are 2 dyes that may be used to investigate this condition.  These dyes are Fluorescein and ICG (Indocyanine Green).  They are injected into the vein and will confirm the diagnosis and highlight the leaking point and source for the fluid at your macula.  This will assist your doctor in planning your treatment.

(2)  OCT (Optical Coherence Tomography)

This highly sensitive device takes a 3D picture of your macula.  It provides accurate measurements of the location and amount of fluid.  It is noninvasive involving “snapshots” much like a camera.  It is very helpful in monitoring improvement or deterioration of the condition.

 

Treatment:

(1)  Observation:

The vast majority (90%) will improve with time.

(2)  “Hot” Laser

Here a special laser is used to seal the leaking source.  It can only be used if the leaking source is well away from the centre of your macula.  It is used if the fluid has not improved after an adequate period of observation or in special situations when rapid improvement is required.  E.g. Pilots

(3)  “Cold” Laser

  • Also known as PDT or photodynamic therapy.  Here a special dye called
  • “Verteporfin” is injected into the bloodstream.  It then accumulates near the leaking source and is activated with a special laser that helps to seal the leak.
  • It is utilised in situations when the leaking point is very close to the centre of the macula or in cases where the fluid has been longstanding.
  • Your doctor will discuss the most appropriate treatment for you.

(4)  Stress Reduction:  A good excuse to go away fishing (for the male)!

 

Outcomes:

  • The most likely outcome is for the condition to improve on its own.
  • In 20-40% of patients, they will have more than 1 episode.
  • A smaller proportion can develop the “chronic” form of the disease.

Click here for Central Serous Retinpathy Fact Sheet