| What
is Central Serous Retinopathy?  The
eye is like a tiny camera, with lenses in the front and
film in the back. The film is called the retina. At the
center of the retina is a tiny spot called the macula, which
provides most of the sharp central vision for reading and
similar tasks. The retina has several layers. On the outer
surface are the cells that actually detect the light. Just
outside of the retina is a rich network of blood vessels
that normally leak fluid. Between these two main layers
is a single layer of cells called the Retinal Pigment Epithelium,
or RPE. One of its many functions is to keep fluid from
leaking out of the vascular area into the area under the
retinal surface. Central Serous Retinopathy (or CSR) develops
when a leak forms in the RPE. This results in a tiny blister
of fluid within the macula or reading spot. Symptoms may
include a change in glasses prescription, images looking
smaller, discolored, blurry, dim, or distorted.
How
is CSR Diagnosed?
 Central
Serous Retinopathy usually causes typical symptoms. It may
be associated with either physical or emotional stress,
and can occur at any age, although it is more commonly  diagnosed
in young adults (under 50 years old). Fluid can be detected
in the macula with a dilated eye examination. In many cases,
a special photographic test, called a fluorescein angiogram,
may be ordered to distinguish Central Serous Retinopathy
from other conditions. This is a photographic test of the
retina and does not involve X-rays. After color pictures
are taken, a yellow dye called fluorescein is injected into
the arm vein and photographed as it passes through the retinal
vessels. The photographic appearance of CSR is usually quite
distinctive, helping to confirm the diagnosis. The picture
can also be used as a “roadmap” to guide laser
treatment when this is performed.
Can
Central Serous Retinopathy Be Treated?
The disease
usually cures itself, and in most cases will disappear within
a few months. Healing occurs as surrounding RPE cells slide
over the leak to reseal it. The doctor may recommend that
the patient monitor vision at home using a piece of graph
paper called an Amsler Grid. Sometimes thinning of the RPE
in the leaky area results in mild to moderate vision damage,
but this is fairly unusual. Rarely, abnormal new vessels
may grow causing scar tissue and a threat of permanent vision
loss. Laser is recommended in many of these cases. Laser
treatment may also be recommended if the condition does
not resolve after several months, or if symptoms prevent
necessary activities. Treatment is usually delayed to try
to let the condition resolve itself, and because laser can
rarely worsen the leak. Leakage can recur, although this
is fairly unusual. This can occur at the same site or at
a different site, and it can occur with or without previous
laser.
Your doctor will discuss with you the particular circumstances
of your case, and the risks, benefits, and alternatives
of treatment versus observation. If you have any questions
or notice any changes in your vision, please call us at
913-261-2020.
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to the Retina Center
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