Central serous chorioretinopathy
Central serous chorioretinopathy (CSC) is an eye condition that occurs when fluid builds up under the retina (the layer of cells at the back of your eye which translates light into images).
This build-up of fluid comes from a layer of blood vessels under the retina, called the 鈥榗horoid鈥�. This can cause a localised detachment of the retina, leading to visual disturbances. CSC tends to particularly affect the macula, which is the central part of the retina responsible for sharp vision. As a result, CSC can have a significant impact on daily functioning.
What causes central serous chorioretinopathy?
The exact cause of central serous chorioretinopathy (CSC) is not well understood, but the condition has been associated with a number of factors, including:
- High levels of stress, possibly due to an increased production of cortisol and other stress related hormones
- Oral and topical corticosteroid use
- 鈥榯ype A鈥� personalities 鈥� individuals who are prone to becoming stressed, or have a competitive nature are more susceptible
- Pregnancy, due to hormonal changes during pregnancy
- Hypertension (high blood pressure)
- Genetics 鈥� a family history of CSC may increase susceptibility
- Other associated factors, which are less common and not necessarily causal include:
- Use of stimulants, such as caffeine and alcohol
- Cushing鈥檚 syndrome, which can cause elevated levels of cortisol and stress hormones
- Autoimmune diseases, such as lupus and rheumatoid arthritis (steroid treatment may be the cause)
- Infection caused by the bacterium Helicobacter pylori
- Kidney disease, such as glomerulonephritis
- Sleep apnoea, possibly due to its effects on overall cardiovascular health and stress levels
Understanding these factors can help to manage and potentially prevent episodes of CSC. During a consultation, one of our specialist consultants can help you to consider your risks.
Central serous chorioretinopathy diagnosis
The key investigations for diagnosing and evaluating central serous chorioretinopathy (CSC) include:
- An eye examination 鈥� your consultant will perform a full examination of your eye and retina to detect fluid accumulation or other abnormalities
- Optical coherence tomography 鈥� this non-invasive imaging technique provides detailed cross-sectional images of the retina, enabling your consultant to visualise the fluid under the retina and the extent of retinal detachment, and evaluate the choroidal thickness
- Autofluorescence imaging 鈥� this simple imaging technique uses naturally occurring fluorescence from the retina to assess the health of the retinal pigment epithelium (RPE), a key layer of cells which is damaged or dysfunctional in this condition
- Fluorescein angiography (FA) 鈥� this involves injecting fluorescein dye into the bloodstream. Once the dye has reached the blood vessels in your retina, your consultant will take a series of photographs of the retina to help identify any leakage points and the exact location of the fluid accumulation, and the extent of damage to the RPE
- Indocyanine green angiography 鈥� this is a similar technique to FA but uses a different dye which is particularly useful for visualising the deeper layers of the choroid, the layer where most of the problem lies in CSC
- Optical coherence tomography angiography 鈥� this technique provides a more detailed analysis of your retina to detect any secondary complications, such as new vessel growth, which may have arisen in cases of chronic or persistent CSC
These investigations can help to confirm the diagnosis of CSC, determine the severity of the condition and guide the management and best treatment approach.
Wondering if you might have CSC? Book an appointment with one of the specialists at AOA体育平台 Eye Centre today.
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Central serous chorioretinopathy treatments
Many cases of central serous chorioretinopathy (CSC) resolve spontaneously within one or two months. During this period, your consultant will continue to check on the progression of the condition and assess whether further intervention is needed.
If your CSC is particularly symptomatic, severe or chronic, your consultant may recommend one of the following treatment approaches:
- Reducing or discontinuing corticosteroid therapy 鈥� this will depend on whether your consultant considers these medications to have been a contributing factor, this decision is jointly made between the patient, the ophthalmologist and the doctor who has prescribed the steroid treatment
- Photodynamic therapy 鈥� this involves using a light-sensitive drug (verteporfin) and a non-thermal laser to seal leaking blood vessels in the retina
- Focal laser therapy 鈥� this treatment can help to settle an episode of leakage from solitary leaking points if they鈥檙e not impacting the very centre of your retina
- Lifestyle changes 鈥� such as stress management techniques (e.g. meditation and counselling) and avoiding stimulants
- Anti-vascular endothelial growth factor (anti-VEGF) injections 鈥� this treatment can treat new blood vessels adding to fluid leakage, only used if this secondary complication arises
- Micropulse laser therapy 鈥� using small, short, low-energy laser pulses to target the epithelium without damaging the retina, this treatment is not usually considered as a first line option
Your consultant may recommend any combination of these approaches, depending on the severity of your condition, the underlying causes and your overall health.
Regular follow-ups with your consultant will be needed to ensure the condition is being managed properly and you are able to recover properly.
Frequently asked questions (FAQs)
Men between the ages of 30 and 50 are more likely to develop central serous chorioretinopathy (CSC) than women. In addition, people under a lot of stress are more likely to be affected by the condition.
It may not be entirely possible to prevent central serous chorioretinopathy (CSC), as you may be genetically predisposed to developing the condition. However, you can reduce your risk by managing your stress levels and limiting the use of corticosteroids.
Rarely, as in most people, central serous chorioretinopathy (CSC) resolves on its own and does not cause any long-term visual changes. The condition itself may reoccur, however, and recurrent CSC is more likely to cause permanent changes to your vision. As a result, it鈥檚 important to make sure you鈥檙e managing your risks.
Most people recover from central serous chorioretinopathy (CSC) within four to six months. Some people, however, can develop chronic CSC, which lasts for longer than 12 months.