What is central serous chorioretinopathy (CSCR)?
Central serous chorioretinopathy (CSCR) is a retinal disorder characterized by fluid accumulation beneath the retina, causing blurred or distorted central vision. It most often affects middle-aged adults , particularly men, and is associated with stress, steroid use, and certain lifestyle factors.
Causes and risk factors
- Stress: Psychological stress and type A personality traits are strongly linked to CSCR.
- Steroid use: Systemic or topical corticosteroids (including nasal sprays and skin creams) can trigger or worsen CSCR.
- Lifestyle factors: High stress, sleep disturbances, and vigorous physical activity may increase risk.
- Medical conditions: Hypertension, Cushing’s disease, and pregnancy are associated with CSCR.
- Genetic factors: Family history and certain genetic variants may predispose to CSCR.
Symptoms
- Blurred or distorted central vision
- Metamorphopsia (wavy or distorted straight lines)
- Micropsia (objects appear smaller)
- Central scotoma (dark spot in central vision)
- Mild color vision changes
- Sudden onset, often painless
Diagnosis
Diagnosis involves a comprehensive eye exam and imaging tests, including:
- Optical coherence tomography (OCT): Non-invasive imaging showing fluid under the retina.
- Fluorescein angiography (FA): Identifies leakage points.
- Indocyanine green angiography (ICGA): Assesses choroidal vascular abnormalities.
- Fundus autofluorescence: Evaluates retinal pigment epithelium (RPE) damage.
Treatment options
- Observation: Most acute cases resolve spontaneously within 3–6 months without
- Lifestyle modifications: Stress management, sleep hygiene, and avoiding steroids are essential.
- Photodynamic therapy (PDT): Effective for chronic or recurrent CSCR, reducing fluid and improving vision.
- Mineralocorticoid receptor antagonists: Eplerenone or spironolactone may help in chronic cases.
- Focal laser photocoagulation: Occasionally used for persistent leakage.
Prognosis and recurrence
Most patients regain near-normal vision after spontaneous resolution. Chronic or recurrent CSCR can cause permanent vision loss due to RPE atrophy or choroidal neovascularization.
Recurrence occurs in 30–50% of patients, often linked to ongoing stress or steroid exposure.
Our approach
We provide comprehensive, individualized care, including advanced imaging, lifestyle counseling, and evidence-based treatments such as PDT and mineralocorticoid receptor antagonists. Our goal is to restore vision, prevent recurrence, and support long-term eye health.
Patient Resources
- American Academy of Ophthalmology (AAO) – Central Serous Retinopathy
- American Society of Retina Specialists (ASRS) – Central Serous Chorioretinopathy
If you have additional questions or need support, please contact our office. We are here to help you every step of the way.