Central serous retinopathy

Central serous retinopathy (CSR) is also known as central serous chorioretinopathy or CSCR. In CSR the macula becomes separated from the eye tissue behind it, and fluid builds up in the space created. This is six times more common in men than women, and most often affects people aged between 20 and 50. It normally affects one eye and up to half of people who get it once will have it again.

What causes central serous retinopathy?

Unfortunately, it is not known what causes the macula to become separated from the eye tissue behind it, and fluid to build up, but research shows that stress can make it worse. A group of drugs called corticosteroids can also trigger CSR or make it worse, and increased levels of the hormone cortisol (which tend to be higher in people with sleep apnoea, Cushing’s syndrome, or who work irregular shifts) seem to make it more likely too. There is also some evidence it could be triggered by a bacterial infection called H. pylori, some other drugs, or even pregnancy.

What are the symptoms?

As the macula swells and separates from the tissues behind it, you may notice a blurred or missing spot in your central vision, some distortion, or things looking smaller than usual. You may also notice changes to your colour vision or have difficulty adapting to changes in light levels.

Treatment

In most cases, the fluid is reabsorbed without any treatment. The majority of people with CSR will regain most or all of the sight they had before. If the fluid is still there after three to six months, you may need treatment to prevent more lasting damage to the macula. 

One treatment option is using a laser to seal off the leak, but it cannot be used too close to the centre of the macula, as it can damage your central vision. If this is the case, you may be offered photodynamic therapy. This is where a drug is injected into your bloodstream and activated in the eye using a low-energy laser, which won’t damage the macula. You should also be helped to make any lifestyle changes that might help, such as reducing stress or stopping any drugs which could make the condition worse.  

Research

One study is looking at whether a drug currently used to treat heart failure could also treat CSR. Another is testing heat shock therapy, using a low-energy laser to renew retinal cells and help them get rid of the fluid faster.