Central Serous Retinopathy

Central serous retinopathy is a medical condition that occurs when fluid builds up behind the retina in your eye. The fluid comes from a layer of blood vessels beneath your retina called the choroid. This fluid can cause your retina to detach, leading to vision loss or other vision problems.

Your retina is a layer of tissue behind each eye. It senses light and translates it into images your brain can understand.

Other names for central serous retinopathy include:

• Central serous chorioretinopathy
• Central serous choroidopathy

Central serous retinopathy affects about 10 out of every 100,000 people, depending on your sex and other risk factors.

Symptoms of central serous retinopathy

Central serous retinopathy can affect one eye or both at the same time. Central serous chorioretinopathy symptoms may include:

• Blurry vision, like a smudge in the center of your sight
• Dark spot in the center of your vision
• Darker or dim vision
• White items look dull or somewhat brown
• Objects seem smaller or further away than they are
• Straight lines look crooked or bent

But central serous chorioretinopathy doesn’t always cause symptoms. A person can have the condition but not have vision problems.

Central serous chorioretinopathy causes

Scientists don’t fully understand what causes central serous retinopathy. Stress appears to play a key role. Stress makes your body release a hormone called cortisol, which can cause inflammation and fluid leakage. People with high stress levels and reduced coping skills are at a higher risk for central serous retinopathy.

The condition is also associated with the use of medications containing corticosteroids, which treat inflammation.

Risk factors for central serous retinopathy

Central serous retinopathy can affect anyone, but it’s more common in:

• Males between the ages of 30 and 50
• People with myopia (nearsightedness)
• Those taking certain medications, especially corticosteroids

Other risk factors include:

• Autoimmune diseases, like lupus and rheumatoid arthritis
• Heart disease or high blood pressure
• Infection with the bacterium Helicobacter pylori
• Kidney disease, like glomerulonephritis
• Pregnancy
• Sleep problems, like sleep apnea and insomnia
• Use of certain medications, like those that treat nasal congestion and erectile dysfunction

How doctors diagnose central serous chorioretinopathy

If you have changes to your vision, seek medical attention from your primary care provider or an ophthalmologist (eye specialist). They’ll talk to you about your symptoms and perform an eye exam. They may also order certain retina tests, including:

• Fluorescein angiography (IVFA). A healthcare provider injects a dye into a vein in your arm that spreads to your retina. Then, they take pictures with a special camera to identify leaks.
• Optical coherence tomography (OCT). A scan that provides 3D pictures of your retina so your provider can measure retinal thickness, identify swelling and detect serous retinal detachment.

What is the treatment for central serous retinopathy?

Many cases of central serous retinopathy go away on their own over a few weeks or months. Your healthcare provider may recommend monitoring, or a “watch and wait” approach. During the monitoring period, they’ll repeat tests to ensure the fluid is draining.

Your provider may also ask you to stop taking medications that contribute to the eye condition. They’ll counsel you to reduce your stress levels.

If the fluid doesn’t drain on its own in a few months, your provider may recommend central serous chorioretinopathy treatment, including:

• Medications. Some medications, like anti-vascular endothelial growth factor, can prevent new blood vessels from growing in your eyes. Certain diuretics can help reduce fluid.
• Photodynamic therapy (PDT). A healthcare provider injects a drug called verteporfin into your arm that travels to your eye. Then, they use a cold laser to close the leak.
• Other laser treatments. After giving you numbing medications, your provider may use thermal laser treatment (a heated laser) to seal leaks. Micropulse laser uses smaller, shorter laser pulses.

How do I take care of myself with central serous retinopathy?

Some lifestyle changes can help you manage central serous retinopathy:

• Get at least seven hours of sleep every night
• Limit caffeine, alcohol and corticosteroids
• Manage and reduce stress with exercise, meditation, time with loved ones or counseling

If you’re experiencing vision loss, some coping strategies include:

• Joining a support group to meet people who understand
• Talking to loved ones or a counselor about your feelings and ways to cope
• Using aids to help you complete daily tasks safely

When should I see my healthcare provider for vision changes?

If you experience any changes to your vision, talk to your primary care provider or an ophthalmologist.

Even though central serous chorioretinopathy can go away on its own, it can get worse and cause permanent vision changes or loss. And sometimes, vision problems are a sign of underlying disease.

What can I expect if I have central serous chorioretinopathy?

Many cases of central serous retinopathy go away on their own as fluid naturally drains. But treatment may be necessary if the condition continues for several months.

After the condition resolves, vision generally improves on its own, often returning to normal. But sometimes, damage can be permanent, with vision changes that don’t improve.

The condition can happen again, even after successful treatment, in the same eye or your other eye. For this reason, you may need regular follow-up appointments with an ophthalmologist.