Central Serous Chorioretinopathy (CSCR)

There are two main types of CSCR:

• Acute CSCR usually resolves on its own within a few months without treatment.
• Chronic CSCR lasts longer, causes repeated fluid build-up, and may damage vision if untreated.

The severity and duration of CSCR symptoms. These symptoms include:

• Blurring or distortion of central vision in one eye (the most common symptom).
• Dark spots appearing in the central field of vision.
• Heightened sensitivity to contrast.
• Reduced ability to see colours clearly.
• Objects appearing smaller than their actual size (micropsia).

The exact cause of CSCR has not fully understood, but, several risk factors have been identified:

• Psychological stress, including trauma or high work pressure, increases the risk.
• Excessive or long-term corticosteroid use (such as oral, inhaled, or topical administration).
• Type A personality, characterised by competitiveness and high psychological stress, is shown to be a risk factor for CSCR.
• Underlying conditions such as high blood pressure, sleep apnoea, or pregnancy can also raise the risk.

Doctors use several tests to diagnose CSCR, they include:

• Retinal examination involves dilating the pupils with special eye drops and using a slit-lamp or ophthalmoscope to check the retina for fluid or damage.
• Visual acuity tests, which measure how clearly a person can see at different distances.
• A medical history review, which helps identify risk factors such as stress or steroid use.
• Imaging tests such as optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography are used to assess retinal involvement and confirm retinalfluid leakage.

Most cases of CSCR improve naturally, but treatment may be needed for persistent or severe cases:

• Routine eye checkups are often recommended for mild or early-stage CSCR, as the condition can resolve on its own.
• Lifestyle modifications such as reducing stress levels, and avoiding unnecessary steroid use can support recovery.
• Photodynamic therapy (PDT) can seal leaks in the choroidal blood vessels for patients with advanced CSCR and can help mitigate fluid accumulation in the retina.
• Micro-pulse and low-power laser therapies may help the retina, promoting fluid absorption.
• Anti-vascular endothelial growth factor (VEGF) drugs can help treat CSCR by suppressing abnormal blood vessel formation under the retinal layers.

Although CSCR causes discomfort and temporarily impairs vision, early diagnosis and timely treatment can support complete recovery. Seek medical attention if you feel any of the below symptoms:

• Vision blurring, dark spots, or sudden central vision changes should be checked by an eye specialist immediately.
• Persistent  or worsening symptoms after a few weeks require follow-up care.

Although CSCR cannot always be prevented, some measures may lower the risk:

• Managing stress through relaxation techniques and healthy routines helps reduce flare-ups.
• Avoiding unnecessary use of corticosteroids lowers the chance of developing CSCR.
• Maintaining overall health by controlling blood pressure and ensuring good sleep may reduce risk.

CSCR should be assessed by an eye specialist:

• An ophthalmologist is the right doctor to consult for diagnosis and treatment.
• A retina specialist may be required for advanced cases or when treatment such as laser or injections is needed.