Central Serous Retinopathy


Central serous retinopathy (CSR) is a condition where fluid accumulates under the retina and symptoms generally include blurred, distorted vision or micropsia (objects appearing smaller). It is typically more common in middle-aged males. The specific cause of CSR is unknown but it is thought to be associated with stress, fatigue and steroid use.

The black dome-shaped area is where the fluid accumulates in central serous retinopathy

Patients with suspected CSR are required to have investigations such as a fluorescein angiogram and an OCT scan to determine the site of fluid leakage and confirm the diagnosis. The OCT scan is very important as it provides information on fluid accumulation inside the retina. It is also useful in following the progression of the condition as it gives an indication of how much fluid remains under the retina with each follow-up.

Treatment usually involves a period of initial observation (for approximately 3-6 months) as some cases of CSR can resolve spontaneously without any treatment. If the condition does not improve, photodynamic laser therapy or focal laser can be very effective in resolving the fluid and improving vision. A course of eplerenone can sometimes be effective in reducing the leakage into the CSR.  

There are some cases of CSR which are linked to wet macular degeneration and treatment for these cases may include anti-VEGF intravitreal therapy to treat the neovascular membrane that may be the causative factor.