Central serous choroidopathy 22/03/2013

What is central serous choroidopathy?

Central serous choroidopathy, also known as central serous chorioretinopathy (CSC) or central serous retinopathy (CSR), is a relatively frequent eye complaint that affects healthy children and adults alike. It leads to loss of vision and is probably the most frequently retinal illness after retinal detachment.

Various risk factors have been associated with it that can make this problem more likely to appear in predisposed people: the administration of certain drugs, especially corticosteroids via any channel, and stressful situations.

Causes 

CSC is a pathology characterised by a focal disruption in the permeability of the retinal pigment epithelium. This situation is due to fluid escaping from the choroids, the layer of blood vessels located under the retina, in the subretinal space, leading to neurosensory retinal detachment and usually, although not necessarily, affecting the macular and foveal region. This detachment means that the light receptors are not adequately supplied and therefore stop working properly.

Symptoms 

Several symptoms have been observed: a blurred, dark blind spot in the centre of vision, the distortion of straight lines in the affected eye and even objects appearing to be smaller or further away in the affected eye.

How is it treated? 

A thorough ophthalmological examination is crucial, which also includes the following tests: a retina scan, autofluorescence, optical coherence tomography and indocyanine green angiography (ICGA).

In some cases this problem spontaneously resolves itself with little or no permanent loss of sight. In others, especially when it does not improve within a few weeks and there are leaks outside the fovea, focal treatment via laser photocoagulation can be highly effective and successful.

It is advisable to avoid the chronic accumulation of fluid within or under the retinal layers as, in the medium or long term, this can atrophy the more external layers of the retina resulting in severe, irreversible loss of sight due to cystoid macular degeneration or permanent retinal pigment epithelium decompensation. If the injuries cannot be treated via laser photocoagulation, photodynamic therapy can be used to seal the leaks and attempt to restore vision, as well as to prevent any further deterioration.

At the Institut we can apply a wide range of therapies for cases of CSC. Apart from conventional argon laser, we also have MicroPulse laser technology, using a very low-level laser with an extremely short, repetitive pulse rate that results in a safe, effective method to treat selected cases of CSC, as well as some cases of macular oedema due to other causes. On specific occasions, the administration of angiogenesis inhibitors can also be useful.