Central Serous Retinopathy (CSR)
A common cause of blurred central vision in young adults.
CSR is a leak of fluid under the macula, often triggered by stress, steroids or type-A personality. Most cases resolve spontaneously; chronic cases benefit from targeted therapy.
Do I need treatment?
Acute CSR is observed for 3 months as most resolve spontaneously. Chronic or recurrent CSR may require micropulse laser or photodynamic therapy.
What is central serous chorioretinopathy (CSCR)?
CSCR is a condition in which fluid leaks under the macula from the choroid, causing a small blister of retinal detachment right at the fovea. Patients - most commonly men aged 25-50 - experience blurring, distortion, a slightly darker or dimmer central spot, and reduced colour saturation. Vision typically recovers spontaneously over 3-4 months in about 80% of cases.
Triggers and lifestyle factors
Steroid medications (topical, inhaled, tablets or joint injections) are the single biggest trigger - please tell us about every steroid you have used, no matter how small a dose. Other triggers: high stress, Type-A personality, obstructive sleep apnoea, uncontrolled hypertension, and - in some - Helicobacter pylori infection.
When and how we treat CSCR
First-line - observe for 3 months while removing steroids, treating OSA, managing stress. If the fluid persists at 3 months or vision drops significantly, we offer photodynamic therapy (half-fluence PDT), focal laser or micropulse laser depending on the leak location. Anti-VEGF has a limited role except in chronic CSCR with secondary neovascularisation.
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