Central Serous Chorioretinopathy

Central serous chorioretinopathy (CSC) is a condition where fluid accumulates underneath the retina. This fluid accumulation occurs due to altered function of the retinal pigment epithelium (RPE). CSC occurs primarily in healthy men between 25-55 years of age, but can also occur in women.

CSC symptoms include:

Sudden onset blurred and dim vision, micropsia (objects appear smaller than they are), metamorphopsia (objects appear distorted) and decreased color vision. 

Risk factors for CSC include:

Stress, steroid use, type A personality (aggressive and competitive behavior), sleep disturbances, high blood pressure, pregnancy, stimulants and decongestants. 

CSC diagnosis:

Dilated fundus examination reveals the presence of subretinal fluid that can be confirmed performing an optical coherence tomography (OCT). OCT is an exam that provides detailed three-dimentional images of the retina. The diagnosis can be confirmed with a fluorescein angiography (FA). FA is a study where a dye is injected into a vein in your arm and photographs of the retina are taken as the dye passes through the retina vessels. 

Central Serous Retinopathy with Smokestack Leakage on Fluorescein Angiography.Thomas A. Ciulla, M.D., MBA | ASRS Image Bank, 2015

Management of CSC:

Most eyes (80-90%) undergo spontaneous resorption of the fluid within 3-4 months. Some cases may require treatment which includes: laser photocoagulation, photodynamic therapy (PDT), micropulse laser, eye injections and oral medications. 

CSC may recur in up to half of the patients.  Long term accumulation of subretinal fluid can lead to permanent vision loss, therefore, regular follow ups are recommended after the subretinal fluid resolve.