Central serous retinopathy
What is central serous retinopathy (CSR)?
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.
It is six times more common in men than women, and most often affects people aged between 20 and 50.
It normally affects only one eye, and up to half of people who get it once will have it again.
What is the macula?
The macula is part of the retina at the back of the eye. It is only about 5mm across but is responsible for all of our central vision, most of our colour vision and the fine detail we see. A healthy macula is about 250 microns (one quarter of a millimetre) thick.
What causes central serous retinopathy?
Unfortunately, it is not known what causes the macula to become separated from eye tissue, 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 or Cushing's syndrome) 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 of central serous retinopathy?
As the macula swells and separates from the tissues behind it, you may notice a blurred or missing spot in your central vision, 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.
How is central serous retinopathy treated?
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.
One recent study looked at whether a drug currently used to treat heart failure could also treat CSR, but unfortunately found that it was no better than placebo (pretend treatment).
Another study is testing heat shock therapy: using a low-energy laser to renew retinal cells and help them get rid of the fluid faster.
Find out more about the latest research into macular conditions, and how you could help us find a cure faster.
For information about living with a macular condition, call the Advice and Information Service on 0300 3030 111 or email firstname.lastname@example.org