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Central serous choroidopathy

Central serous choroidopathy is a disease that causes fluid to build up under the retina , the back part of the inner eye that sends sight information to the brain. The fluid leaks from the blood vessel layer under the retina. This area is called the choroid.

Alternative Names

Central serous retinopathy

Causes, incidence, and risk factors

The cause of this condition is unknown.

Men are affected more often than women, and the condition is most common at around age 45, but anyone can be affected.

Stress appears to be a risk factor. Early studies found that people with aggressive, "type A" personalities who are under a lot of stress may be more likely to develop central serous retinopathy.

The condition can also occur as a complication of steroid drug use.

Symptoms

  • Dim and blurred blind spot in the center of vision
  • Distortion of straight lines with the affected eye
  • Objects appearing smaller or farther away with the affected eye

Signs and tests

Your health care provider can usually diagnose central serous choroidopathy by dilating the eye and performing an eye exam. Fluorescein angiography confirms the diagnosis.

It may be done with a noninvasive test called ocular coherence tomography (OCT).

Treatment

Most cases clear up without treatment in 1 or 2 months. Patients with more severe leakage and more severe visual loss, or those in whom the disease lasts longer, may be helped by laser treatment or photodynamic therapy to seal the leak and attempt to restore vision.

Patients who are using steroid drugs (for example, to treat autoimmune diseases) should stop using them, if possible. Any change in steroid drug use in these conditions must be under the supervision of a physician.

Expectations (prognosis)

Most patients recover good vision without treatment, although it's often not as good as it was before the condition occurred.

The disease returns in about half of all patients, and has a similarly good outlook. Rarely, patients develop permanent scars that damage their central vision.

Complications

A small number of patients will have complications of laser treatment that impair central vision. That is why most patients will be allowed to recover without treatment.

Calling your health care provider

Call your health care provider if your vision gets worse.

Prevention

There is no known prevention. Although there is a clear association with stress, there is no evidence that reducing stress has any benefit in preventing or treating central serous choroidopathy.

References

Kitzmann AS, Pulido JS, Wirostko WJ. Central serous chorioretinopathy. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 6.29.

Geraets RL, Rosa RH Jr. Pathology of the retina. In: Tasman W, Jaeger EA, eds. Duane's Foundations of Clinical Ophthalmology. 2012 ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2012: chap 13.

Wang M, Munch IC, Hasler PW, Prante C, Larsen M. Central serous chorioretinopathy. Acta Ophthalmol. 2008;86:126-145.

Updated: 9/3/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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