Central serous chorioretinopathy is when fluid builds up under the retina. This can distort vision. The fluid leakage comes from a layer of tissue under the retina, called the choroid. The layer of cells between retina and choroid is called the retinal pigment epithelium (RPE). When RPE does not work as it should, fluid builds up under the retina or the RPE resulting in a small detachment and visual distortion.
This image from an OCT scan
shows how central serous
retinopathy (also called central
serous choroidopathy) causes a
blister-like swelling in layers of
Central serous chorioretinopathy usually affects just one eye at a time, but both eyes can be affected at the same time.
Central serous chorioretinopathy symptoms
Symptoms of central serous chorioretinopathy can include:
- distorted, dimmed, or blurred central vision
- a dark area in your central vision
- straight lines may appear bent, crooked or irregular in your affected eye
- objects may appear smaller or further away than they are
- when you look at a white object, it may appear to have a brownish tinge or appear duller in color
Who is at risk for central serous chorioretinopathy?
Men in their 30s to 50s are more likely to develop central serous chorioretinopathy than women. Stress is a major risk factor. People under a lot of stress may be more likely to develop central serous chorioretinopathy.
Other risk factors for central serous chorioretinopathy are:
- use of corticosteroids (by mouth, topical, inhaled or injected)
- use of phosphodiesterase-5 inhibitor medications (or ED medications, such as Viagra, Cialis, Levitra)
- autoimmune disease (when the body attacks its own tissues)
- obstructive sleep apnea (OSA)
- "type A" personality traits or being overly anxious and stressed out
- Cushing syndrome (an endocrine disorder with elevated cortisol or stress hormone levels)
- hypertension (high blood pressure)
- organ transplantation
Central serous chorioretinopathy diagnosis
Your ophthalmologist dilates (widens) your eye with dilating eye drops to look at your retina.
They will then take special photographs of your eye and possibly fluorescein angiography. During fluorescein angiography, a dye is injected into a vein in your arm. The dye travels throughout the body, including your eyes. Your doctor takes photographs of your eye as the dye passes through the retinal blood vessels. The orange dye will show abnormal areas in your eye. This can help find areas with central serous chorioretinopathy.
Optical coherence tomography (OCT) also helps your doctor look at the retina. A machine scans the back of the eye and provides detailed three-dimensional (3D) pictures of the retina. This helps measure retinal thickness and find swelling of the retina.
Central serous chorioretinopathy treatment
Most cases of central serous chorioretinopathy clear up in one or two months without any treatment. During this time, your ophthalmologist will look at your eye to see if the liquid is going away. Sometimes there is severe vision loss or the leakage does not go away. In these cases, laser treatment, photodynamic therapy, or oral medications may be used. These treatments can seal the leak and restore vision.
Most people with central serous chorioretinopathy regain good vision even without treatment. But vision may not be as good as it was before the condition. About half of patients who have had central serous chorioretinopathy will have it return. It is important to have regular follow-up exams with your ophthalmologist. This is because long-term fluid accumulation can lead to permanent vision loss.