Mr Nicholas Glover  - Consultant Cataract & Vitreoretinal Surgeon
Central Serous Retinopathy 

Central serous retinopathy is an eye condition where fluid accumulates underneath the retina causing distortion and visual loss. Patients are typically 20-50 years old and often complain of a sudden, painless loss of vision.  This condition occurs 8-10 times more commonly in men than in women. It is felt that this may be a stress-related condition as it is more common in patients with “Type A” personalities.

Symptoms 

Patients may be asymptomatic unless the central part of the retina (macula) is affected. In these cases, they note decreased or blurred vision, distortion (metamorphopsia), micropsia (small image size), and abnormal color vision (dyschromatopsia)

Diagnostic Testing 

Fluorescein Angiography 

Fluorescein angiography is a diagnostic test in which intravenous fluorescein dye is administered and photographs are taken of the eyes. In central serous retinopathy, the angiogram typically shows, dye accumulating beneath the retinal detachment but does not go beyond its borders. Most cases show one leakage point. 


Optical Coherence Tomography (OCT) 

OCT is an excellent diagnostic test which clearly demonstrated the serous detachment, especially when the serous detachment is shallow. 


Management 

 For most patients, observation is all that is necessary. If possible, steps to reduce external stressors should be taken. In addition, we advise patients to avoid corticosteroids if possible, as they can worsen the disease. 

Treatment 

Laser  at site of leakage can accelerate resolution but does not result in a better visual acuity, and does not reduce the rate of recurrence. Treatment can be with either laser  photocoagulation or Photodynamic Therapy (PDT). However there is evidence that treatment with specific antihypertensive therapy may also cause resolution. These options will be discussed to see which best suits you. We generally treat patients who meet with the following characteristics: 

 •    A non-resolving serous detachment for at least four months 
 •    A site of leakage away from the foveal center 
 •    An occupational need for expedited visual recovery 

Prognosis 

Fortunately, spontaneous visual recovery is the very common. Approximately 40-50% will recover in less than 6 weeks. This number increases to 80-90% within 6 months.  but some patients may still have minor persistent visual complaints. 

This is a condition that may recur. As many as 40-50% of patients will have one or more recurrences, which can occur many years later. 

About 10% of patients will have 3 or more episodes.