Central Serous Retinopathy

What is Central Serous Retinopathy (CSR)? 

CSR is a condition in which fluid collects underneath the retina at the back of the eye. This results in an elevation of the retina, which affects the vision. Patients often notice a circular grey patch in their vision. They may also notice distortion and that objects appear smaller in the affected eye. 

Illustration: compare the normal retina OCT in the first picture with the CSR-affected retina in the second picture. Notice the black ‘blister of fluid’ in the patient with CSR (second picture).

Fig A: A retinal photo of CSR 

Fig B: Fluorescein angiogram

Fig C: (Immediately after laser):

Fig D: (3 months after treatment)

Illustration: This is an example of a patient with CSR (fig A). After 3 months of reduced vision, a fluorescein angiogram (fig B) was performed which confirmed a small area of leakage that was amenable to laser treatment (fig C). 3 months after treatment (fig D), the fluid has resolved, and the patient has no symptoms.

Remember that CSR most commonly (not always) affects people that have too much stress in their life. It is recommended that you identify the factors causing stress and try to minimise them if possible. Speaking with your GP about such strategies can be very helpful. Such strategies should start without the use of medication (if at all possible). Many people recommend using several different forms of relaxation techniques, modifying work practices and other techniques to reduce stress levels. 

Sometimes reducing or stopping steroid use will allow the CSR to resolve. Please speak with your physician regarding reducing your steroid intake. If you are taking steroids, never stop steroids abruptly without your prescribing doctor’s advice.