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Central Serous Chorioretinopathy - Causes, Symptoms, Diagnosis, Differential Diagnosis, and Management

Written by
Dr. A. Srividya
and medically reviewed by Dr. Shikha

Published on Aug 05, 2022   -  5 min read

Abstract

Central serous chorioretinopathy is the fourth most common disease of the retina and choroid. Read the full article on central serous chorioretinopathy below.

Contents

Introduction

Central serous chorioretinopathy (CSCR) is a localized detachment of the retina also macula. It causes distortion or loss of central vision. It mainly affects the males, especially in the twenty to sixty age group. Above sixty years, the disease shows bilateral involvement. Females involved belong to an older age group. American Africans, Caucasians, and Asians are at a higher risk of contracting CSCR.

What Is Retina?

The retina is present at the back of the eye and helps sense the external light and transfer the formed images to the brain. Retina has a rich meshwork of blood vessels and nerves.

What Is the Main Causative Factor of CSCR?

CSCR is of multifactorial origin. Therefore, no single pinpoint cause is responsible for the development of the disease. However, there is a strong association between the abnormal retinal pigment epithelium (RPE) and CSCR. Other causative factors include:

What Are the Additional Contributing Risk Factors Associated With CSCR?

Numerous factors are linked to the initiation and progression of the disease. These include:

What Is the Mechanism Behind the Formation of CSCR?

It is challenging to elucidate the exact mechanism behind the instigation of CSCR. However, the increase in vessel permeability supplying the middle layer of the eyewall (choroid) and choking (congestion) of the veins leads to fluid leakage from the capillaries. The leak reduced the blood flow (ischemia) and increased hydrostatic pressure in the choroidal network resulting in RPE damage and focal lesions. The retinal blood and external blood barrier break down, thus causing an accumulation of fluid in the subretinal space.

What Are the Different Forms of CSCR?

CSCR is of two forms:

What Are the Clinical Features of CSCR?

The main symptom expressed by patients suffering from CSCR is loss of visual acuity.

How Is CSCR Diagnosed?

Diagnosis of CSCR is mainly made by clinical examination. Imaging and other diagnostic procedures aid in treatment planning and the diagnosis by ruling out other diseases with similar patterns.

What Are the Conditions That Mimic CSCR?

Differential diagnosis of CSCR encompasses all the conditions causing macular detachment. The states with a neurosensory break in the macula include:

How Is CSCR Managed?

CSCR being a limiting condition hardly requires any treatment. However, treatment is advised in case of recurrent or chronic lesions. Therefore, management of CSCR involves both medical and surgical management.

Medical Management of CSCR Comprises Of:

Surgical Management of CSCR:

It is recommended in chronic, long persistent, and recurrent cases.

What Are the Complications of CSCR?

Recurrent and persistent infection of the lesion due to disruption of the retinal architecture leads to some lasting eye complications like:

What Is the Prognosis of CSCR?

CSCR is a self-limiting condition. The acute form of the disease resolves spontaneously. However, management is required in chronic states to minimize further complications. The overall prognosis of the disease is excellent. However, CSCR has a high recurrence rate.

Conclusion

CSCR remains a mysterious disease with a multifactorial cause. The initiation and progression of the disease are still unclear. Blurred vision is the chief problem encountered in these patients. However, most cases get resolved by themselves with good visual acuity.

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Last reviewed at:
05 Aug 2022  -  5 min read

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