CENTRAL SEROUS RETINOPATHY ( CSR )


    It is an idiopathic , self limiting , non inflammatory serous detachment of retina involving posterior pole mainly macula. 

Symptoms

Unilateral central loss or blurring of vision with or without distortion of shape of objects seen. Patient sees central dark ring.

Signs

Vision improves by Plus glasses.

On retina a small elevation may be seen with clear fluid underneath.
Occasionally the elevation may be large and one may confuse it with retinal detachment.

No evidence of inflammation is seen in the eye.



Diagnosis

Clinical examination itself is sufficient to diagnose the disease . Fluorescein angiography will show the leak beginning in early phase at level of retinal pigment epithelium increasing in size in later phases. The leaks are normally uniform.


FFA showing leak in CSR

Management

Disease is mostly self limiting and vision improves in 2 to 3 months in most of the cases. No medical treatment is proved to be of any help. Steroids are contraindicated. Only treatment is laser to the leaks.

Laser for CSR

Indications:

If CSR persists for more than 3 months.

If it is recurrent.

If profession of person demands early visual rehabilitation such as driver, pilot etc

Laser helps by reducing the recovery time to 10- 15 days.

Why laser not in all cases:

Laser in close proximity of fovea may cause foveal burn and permanent decreased vision.

Laser may also increase chances of subretinal neovascularisation and further loss of vision.


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