Central serous chorioretinopathy (CSC), also known as central serous retinopathy (CSR) is a condition where fluid leaks under the retina. The retina is the light-sensitive tissue lining the back of your eye. CSC is most often confined to the macula, a specialised part of the retina responsible for detailed central vision. In CSC, fluid accumulating under the macula can lead to a reduction in vision.
CSC usually affects young to middle-aged adults and is more common in men than women. It can affect one or both eyes and in most cases spontaneously resolves within 1 to 4 months, sometimes persisting for longer. Recurrences are common, occurring in up to half of patients within the first year of the primary episode.
What are the symptoms of CSC?
People with CSC might experience the following symptoms:
• Blurred or decreased vision
• Distorted central vision, where lines appear crooked or bent
• A dark spot in your central vision
• Objects appearing smaller or further away than they really are
• Colours appearing ‘washed out’
What causes CSC?
The exact causes are not fully understood, however certain risk factors may influence the development of CSC, such as:
• Steroids – taken by mouth (tablets), on skin (creams), through veins (injections) or inhaled (nasal-sprays)
• Personality traits, such as type A personality (ambitious, competitive, impatient behaviour)
• Sleep disturbances
How is CSC diagnosed?
CSC is diagnosed and monitored with a dilated retinal exam and Optical Coherence Tomography (OCT), a non-invasive scan of the tissue layers of the retina. Retinal photographs may also be taken to confirm and document the extent of your condition. Fluorescein and/or indocyanine green angiography is usually only required in selected cases and involves specialised imaging of the retina following injection of fluorescein or indocyanine green dye into a vein in the arm.
Image: OCT scan showing fluid under the central macula
How is CSC managed?
Most cases of CSC will resolve spontaneously within 1 to 4 months with fluid leakage being reabsorbed without the need for treatment. The recovery may be accelerated by removal or reduction of steroid use and control of other risk factors such as stress. Observation is the standard management in most cases However, in a small number of cases, orally administered medications may be helpful. If after several months there is no improvement, treatment with specialised lasers (argon laser photocoagulation or photodynamic therapy) may be required to seal off the leakage and reduce / eliminate the fluid under the retina.
Following treatment, your eye care professional will monitor your progression. If CSC recurs or signs and symptoms persist, further treatment may be required.
If you have been diagnosed with CSC it is important to monitor your vision carefully using an Amsler grid and consult your eye care professional immediately if you notice any sudden changes in your vision. Prompt action can save sight.
Macular Disease Foundation Australia exists to provide information and support for people with macular disease, their families and carers. Our Helpline can provide you with a free Amsler grid and further information about your condition, and can advise you on the various supports and services available: 1800 111 709.