Central Serous Retinopathy

What is central serous retinopathy?

Central serous retinopathy is a medical condition that occurs when fluid builds up behind the retina in your eye. The fluid can cause your retina to detach, leading to vision problems or vision loss.

Your retina is a layer of tissue behind each eye. It senses light and translates it into images your brain can understand.

The condition is also called central serous chorioretinopathy.

Who might get central serous retinopathy?

Central serous retinopathy can affect anyone, but it’s more common in:

• Middle-aged men and people assigned male at birth (AMAB).
• People with myopia (nearsightedness).
• Those taking certain medications, especially corticosteroids.

How common is central serous retinopathy?

Central serous retinopathy occurs in about 6 to 10 people per 100,000, depending on assigned sex and other risk factors.

What causes central serous retinopathy?

Scientists don’t fully understand what causes central serous retinopathy. Stress appears to play a key role. Stress makes your body release a hormone called cortisol, which can cause inflammation (swelling) and fluid leakage. Studies have shown that people with high stress levels and poor coping skills are at higher risk for central serous retinopathy.

The condition is also associated with the use of medications containing corticosteroids, which treat inflammation. Corticosteroids come in several forms:

• Creams for your skin to treat dermatologic disorders.
• Inhalers, such as those used to treat asthma.
• Injections into your joints for orthopaedic conditions.
• Nasal sprays.
• Oral tablets such as prednisone.

Other risk factors include:

• Autoimmune disease, such as lupus and rheumatoid arthritis.
• Heart disease or high blood pressure.
• Infection with the bacterium Helicobacter pylori.
• Kidney disease, such as glomerulonephritis.
• Pregnancy.
• Sleep problems, such as sleep apnea and insomnia.
• Use of certain medications, such as those that treat nasal congestion and erectile dysfunction.

What are the symptoms of central serous retinopathy?

Central serous retinopathy can affect one eye or both at the same time. Symptoms might include:

• Blurry vision, like a smudge in the center of your sight.
• Dark spot in the center of your vision.
• Darker or dim vision.
• White items look dull or somewhat brown.
• Objects seem smaller or further away than they are.
• Straight lines look crooked or bent.

However, central serous chorioretinopathy doesn’t always cause symptoms. A person can have the condition but not have vision problems.

How is central serous chorioretinopathy diagnosed?

If you have changes to your vision, seek medical attention from your primary care provider or an ophthalmologist (eye specialist). They’ll talk to you about your symptoms and may order certain retina tests:

• Fluorescein angiography (IVFA): For IVFA, a healthcare professional will inject a dye into a vein in your arm. The dye spreads through your body and into your retina. Then, a healthcare provider takes pictures with a special camera to identify leaks.
• Optical coherence tomography (OCT): A central serous retinopathy OCT scan looks at the back of your eye. It provides three-dimensional pictures of your retina so your healthcare provider can measure retinal thickness, identify swelling and detect serous retinal detachment.

What is the treatment for central serous retinopathy?

Many cases of central serous retinopathy go away on their own over a few weeks or months. So your healthcare provider may recommend monitoring, or “watch and wait.” During the monitoring period, they’ll repeat tests to ensure the fluid is draining.

Your healthcare provider also may ask you to stop taking medications that contribute to the eye condition. They’ll also counsel you to reduce stress.

If the fluid doesn’t drain on its own in a few months, your healthcare provider may recommend central serous retinopathy treatment:

• Medications: Some medications may help treat central serous retinopathy. For example, anti-vascular endothelial growth factor can prevent new blood vessels from growing in your eyes. Certain diuretics can help reduce fluid.
• Photodynamic therapy: For photodynamic therapy, a healthcare provider injects a drug called verteporfin into your arm. The drug travels to your eye. Then the healthcare provider uses a cold laser on the part of your eye that has the leak. The laser on the verteporfin can close a leak.
• Other laser treatments: Thermal laser treatment uses a heated laser to seal leaks. Micropulse laser uses smaller, shorter laser pulses.

How can I reduce my risk of central serous retinopathy?

It may not be possible to prevent central serous retinopathy. But you can reduce your risk by managing stress and limiting the use of corticosteroids.

What can I expect if I have central serous retinopathy?

Many cases of central serous retinopathy go away on their own as fluid naturally drains. But treatment may be necessary if the condition continues for several months.

After the condition resolves, vision generally improves on its own, often returning to normal. But sometimes damage can be permanent, with vision changes that don’t improve.

The condition can happen again, even after successful treatment, in the same eye or your other eye. For this reason, you may need regular follow-up appointments with an ophthalmologist.

How do I take care of myself with central serous retinopathy?

Some lifestyle changes can help you prevent or improve central serous retinopathy:

• Get at least seven hours of sleep every night.
• Limit caffeine, alcohol and corticosteroids.
• Manage and reduce stress, perhaps with exercise, meditation, time with loved ones or counseling.

If you’re experiencing vision loss, some coping strategies include:

• Join a support group to meet people who understand.
• Talk to loved ones or a counselor about your feelings and ways to cope.
• Use aids to help you complete daily tasks safely.

When should I see my healthcare provider for vision changes?

If you experience any changes to your vision, talk to your primary care provider or an ophthalmologist.

Even though central serous retinopathy can go away on its own, it can get worse and cause permanent vision changes or loss. And sometimes vision problems are a sign of underlying disease.

A note from Cleveland Clinic

Central serous retinopathy occurs when fluid builds up behind the retina in your eye. If you have any vision changes or loss, talk to your primary care provider or an ophthalmologist. Early intervention can help ensure that vision problems don’t become permanent.