Central Serous Retinopathy- blog post

Imagine seeing something that looks like a puddle of water in the back of your eye. This analogy best describes the condition central serous chorioretinopathy. Central serous chorioretinopathy is the buildup of fluids in the retina, leading to visual distortion. More specifically, fluid leakage occurs in the layer of tissue underneath the retina, called the choroid. In this condition, the layer of cells between the retina and choroid called the retinal pigment epithelium (RPE) does not work properly, causing small detachment and visual distortion. This condition tends to affect one eye at a time, but in certain cases, it can affect both eyes at the same time. 

Image of swelling in the RPE, resulting in idiopathic central serous retinopathy

Central serous retinopathy is common amongst males, specifically middle-aged men, people with myopia, or nearsightedness, and individuals taking corticosteroids, a type of anti-inflammatory drug. Additionally, statistics also point out that the condition occurs in about 6 to 10 people per 100,000. Symptoms of central serous retinopathy include distorted, blurred, or dimmed central vision, a dark area in on central vision, bent or crooked straight lines in the affected eye, objects appearing smaller or further than they actually are, and increased dullness in clear and white objects. 

Men are at far greater risk than women to develop the condition, especially men in the age range of 30-50. The predominant risk factor for developing central serous chorioretinopathy is stress, and this is due to the fact that stress releases cortisol hormones. In addition to stress, there are also other important risk factors associated with this condition. Examples include use of steroids, bacterial infection in the stomach, autoimmune disease, insomnia and sleep apnea, and hypertension.  Other factors include autoimmune diseases such as lupus and rheumatoid arthritis and kidney disease, specifically glomerulonephritis.

Helicobacter pylori- type of stomach bacterial infection that poses as a risk factor for central serous chorioretinopathy

Central serous retinopathy is diagnosed by an opthamologist using dilating eye drops to widen the eye and look at the retina. In addition, an ophthalmologist may also perform fluorescein angiography, where a dye is injected into a vein in the arm and travels throughout the body, including the eyes. As the dye passes through the blood vessels of the retina, the ophthalmologist will take photographs of the eye, and areas where the dye is orange indicate affected areas that could point towards central serous retinopathy. 

Example of the retina shown via fluorescein angiography,

Most cases of the condition clear up within 1-2 months without any treatment or intervention. At times, however, despite constant monitoring and intervention by an opthamologist, the fluid leakage does not go away. In those cases, laser treatment, photodynamic therapy- injection of the drug verteporfin along with a cold laser, and medications such as anti-vascular endothelial growth factor and diuretics can be used to seal the leak in the choroid. 

Image of photodynamic therapy

https://my.clevelandclinic.org/health/diseases/24335-central-serous-retinopathy#:~:text=How%20common%20is%20central%20serous%20retinopathy%3F%20Central%20serous,Cleveland%20Clinic%20is%20a%20non-profit%20academic%20medical%20center.

https://www.aao.org/eye-health/diseases/what-is-central-serous-