Central serous chorioretinopathy

Central serous chorioretinopathy 

With central serous chorioretinopathy, fluid accumulates under the retina, and vision is distorted. This fluid comes from the choroid, located under the retina. When the cells of the pigment epithelium (one of the layers of the retina) are not functioning properly, fluid accumulates underneath. As a result, the retinal is detached, with the vision is distorted.

What are the symptoms of central serous chorioretinopathy?

Central serous chorioretinopathy can have the following symptoms:

• objects in the centre of the field of vision are distorted, blurry or hazy;
• dark spot in the centre of the field of vision;
• straight lines appear crooked, curved, or broken.
• objects seem to be smaller or more distant than they really are;
• white objects turn brown or blurry.

Terms

Retina is a layer of nerve cells, located on the inner surface of the eye. The retina senses light and sends signals to the brain, with images formed out of these signals in the brain.

Choroid is the layer containing blood vessels and connective tissue located between the sclera and the retina. Nutrients and oxygen enter the eyes through the choroid.

Retinal pigment epithelium is a layer of cells between the retina and the choroid. If the pigment epithelium is healthy, fluid from the choroid will not flow to the retina.

Who has the highest risk of developing central serous chorioretinopathy?

Most often, central serous chorioretinopathy occurs in men between the ages of 30 and 50. Stressful situations also increase the risk of central serous chorioretinopathy.

Other risk factors:

• use of steroids (in tablets, intravenous or inhalation);
• Helicobacter pylori – a bacterium which causes inflammation of the stomach in humans (gastritis);
• autoimmune diseases (when the immune system attacks its own tissues);
• sleep disorders: insomnia (when it is difficult for a person to fall asleep, or he or she wakes up often) and sleep apnoea;
• conduct disorder (aggressive and competitive);
• arterial hypertension (high blood pressure).

How is central serous chorioretinopathy diagnosed?

First, the ophthalmologist will dilate your pupil with eye drops to examine the retina with a special lens.

The ophthalmologist will then take a photo of the retina and possibly perform fluorescence angiography. A yellow dye (fluorescein) is injected into a vein of the arm, and the dye enters the retina through the blood vessels. At this time, it is photographed with a special camera. The symptom of central serous chorioretinopathy is accumulation of clumps of orange dye.

Another method of examining the retina is optical coherence tomography (OCT). A special device scans the retina and forms detailed images of the retina and macula.

These images help to measure thickness of the retina and find areas of oedema.

 How is central serous chorioretinopathy treated?

 In most cases, central serous chorioretinopathy secedes without treatment within one or two months. Within this time, the ophthalmologist will regularly examine you and monitor how the fluid under the retina is absorbed. In some cases, the leakage of fluid from the vessels does not stop, with the vision deteriorating significantly. In this case, to recover your vision and stop fluid leakage, doctors prescribe laser treatment, photodynamic therapy or medications.

Most often, central serous chorioretinopathy does not lead to significant visual impairment, even if not treated. However, sometimes vision still suffers. In every second patient, central serous chorioretinopathy reappears over time. Therefore, you should definitely visit an ophthalmologist regularly, because if the fluid under the retina does not dissolve for a long time, this can lead to irreversible loss of vision.

Summary

Central serous chorioretinopathy is an accumulation of fluid under the retina which impairs vision. Central serous chorioretinopathy is more common in men.

With central serous chorioretinopathy, objects become blurry and dull, and may appear smaller or more distant than they actually are. A blind (dark) spot may appear in the field of vision.

If the ophthalmologist suspects central serous chorioretinopathy, in order to establish a diagnosis, it will be necessary to dilate the pupil with eye drops and photograph the retina with a special camera to identify areas of retinal oedema.

Most often, central serous chorioretinopathy goes away without treatment. It is necessary to regularly visit an ophthalmologist and monitor the process of resorption of fluid under the retina. If the fluid does not disappear, you can apply laser treatment, photodynamic therapy, or medications.

For questions about visual impairment, be sure to contact an ophthalmologist. The doctor will make every effort to preserve your vision.