Central serous chorioretinopathy

Central serous chorioretinopathy: Description, Causes and Risk Factors:Abbreviation: CSCR.Central serous chorioretinopathy is a condition that usually affects younger people and is characterized by a build-up of fluid underneath the retina. The retina sits on-top of a layer called the choroid, which is what supplies most of the retina with oxygen and nutrients. A layer of tissue called the retinal pigment epithelium (RPE) separates the choroid from the retina and prevents the accumulation of fluid between the two tissues. When small breaks occur in the RPE, serous fluid (the clear part of blood) pools under the retina, causing the retina to swell and lift off the layer below it. The cause of these breaks is unknown, though there has been a well documented association between central serous chorioretinopathy and stress. Cortisol, which has been linked to CSCR, is a natural steroid that is released by the body when a person is under stress. Artificial steroids taken orally or ointment on the skin can also cause CSCR. Some studies have shown an association between sleep apnea and CSCR. In most cases, the condition only occurs in one eye, though in some cases it can occur in both eyes at the same time.CSCR commonly occurs in men between the ages of 25 and 50. Though CSCR predominately occurs in males, it can also occur in females as well (a ratio 8:1). The incidence rate of CSCR within the United States is about 9.9 per 100,000 for men and about 1.7 per 100,000 for woman. Factors that have been associated with an increased risk of developing CSCR include:Male.
  • Age between 25-50.
  • Systemic steroid use.
  • Type A personality.
  • Stress.
  • Sleep apnea.
Most patients with central serous chorioretinopathy will spontaneously recover visual acuity in 6 months (average time to recover 3-4 months). Many patients will have some residual symptoms such as distortion, decreased color and contrast sensitivity, as well as visual difficulty at night. Despite an overall good prognosis, 40-50% of patients experience one or more recurrences.Central serous chorioretinopathySymptoms:Some patients may have no symptoms; however, most patientscomplain of one or more of the following symptoms:Decreased vision. Diagnosis:The ophthalmologist will perform a dilated exam using a slit lamp todetermine the amount of fluid is under the retina and what extent itis having on the macula. To check the outer retina, the doctor willuse an indirect ophthalmoscope. Testing is important because ithelps the ophthalmologist to precisely document the condition, check forswelling, and measure changes that occur over time. The three typesof tests usually needed are:Optical Coherence Tomography (OCT): It is a high definitionimage of the retina taken by a scanning ophthalmoscope with aresolution of 5 microns. These images can help determine theamount of fluid under the retina and how much swelling ispresent. The doctor will use OCT images to objectivelydocument the progress of the disease throughout the course ofyour treatment.
  • Fluorescein Angiography (FA): It is a test that documents bloodcirculation in the retina using fluorescein dye which luminescesunder blue light. Fluorescein is injected into a vein in your armand digital fundus pictures are taken afterwards for 10 minutes.The pictures are used to determine the exact point and extent ofleakage.
  • Indocyanine Green Angiography (ICGA): It is a test that images thechoroid using infrared light. This test is used to determine ifthere is any vascular abnormalities and/or leaking within thechoroid.
Treatment:Central serous chorioretinopathy usually resolves on its own and the doctor will closely follow you over a three month period. If the condition does not resolve during this time period or if it affects your quality of life and daily activities, treatment may be necessary. Photodynamic Therapy (PDT) is a treatment that uses a photoreactive dye that is activated by a laser to seal the area of leakage. Your condition and the associated risks and benefits of PDT will be discussed with you prior to deciding whether treatment is the proper course of action.Common complications:Scotoma (field loss) or grey spots about fixation.
  • Ocular irritation, discomfort or redness.
Rare or uncommon complications:Corneal abrasion.
  • Hemorrhage or bleeding.
  • Retinal artery or vein occlusion.
  • Choroidal neovascularization or abnormal new subretinal vessels.
  • Inadvertent foveal ablation or laser treatment of the reading center.
  • Retinal tears/detachment.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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