Central Serous Chorioretinopathy (CSCR)

Central Serous Chorioretinopathy (CSCR) is a condition that causes fluid to build up underneath the center of the retina (Macula). Fluid leaks from the blood vessel layer under the retina called the choroid. It is more common in men and typically occurs between the ages of 25 to 50 years.

What are the symptoms?

Most patients have a blurred spot in the center of vision. Objects often appear distorted and miniature in size, sometimes appearing farther away in the involved eye. Colors can appear washed out. Rarely is vision severely affected. Most cases affect only one eye, but it can involve both.

What causes it?

The exact cause of CSCR is unknown. However, corticosteroid use in any form (oral, topical, inhaled, or injected) can precipitate or worsen an attack of CSCR. This is true even if the steroid use is remote from the eye, such as an injection into the knee. People who have a history of CSCR should avoid any steroid use if possible.

What is the follow-up and treatment?

In most cases, the fluid under the retina resolves spontaneously over several months and the final visual outcome is usually good, although not always perfect. Given the favorable natural history of this condition, patients are usually followed without treatment. The condition recurs in 20% to 30% of patients. Some degree of permanent visual loss can occur in CSCR and this is more likely in recurrent or prolonged cases.

Laser treatment can help to speed the resolution of subretinal fluid and improve vision faster in some cases. In general, treatment is usually reserved for certain circumstances, such as when there is persistence of subretinal fluid for four to six months or more, recurrence in an eye that sustained a permanent visual loss from a previous episode, or need for prompt visual restoration such as for occupational reasons. Alternative treatments include photodynamic therapy and an intraocular injection of Avastin.