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CENTRAL SEROUS RETINOPATHY ( CSR )
It is an idiopathic , self limiting , non inflammatory serous detachment of retina
involving posterior pole mainly macula.
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Symptoms
Unilateral central loss or blurring of vision with or without distortion of shape of objects seen.
Patient sees central dark ring.
Signs
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Vision improves by Plus glasses.
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On retina a small elevation may be seen with clear fluid underneath.
Occasionally the elevation may be large and one may confuse it with retinal detachment.
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No evidence of inflammation is seen in the eye.
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Diagnosis
Clinical examination itself is sufficient to diagnose the disease . Fluorescein angiography will show the leak beginning in early phase at level of retinal pigment epithelium increasing in size in later phases. The leaks are normally uniform.
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FFA showing leak in CSR |
Management
Disease is mostly self limiting and vision improves in 2 to 3 months in most of the cases. No medical treatment is proved to be of any help. Steroids are contraindicated. Only treatment is laser to the leaks.
Laser for CSR
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Indications:
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If CSR persists for more than 3 months. |
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If it is recurrent. |
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If profession of person demands early visual rehabilitation such as driver,
pilot etc |
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Laser helps by reducing the recovery time to 10- 15 days. |
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Why laser not in all cases:
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Laser in close proximity of fovea may cause foveal burn and permanent decreased vision.
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Laser may also increase chances of subretinal neovascularisation and further loss of vision.
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