Central Serous Choroidopathy

Central serous choroidopathy is a disease that causes fluid to build up under the retina.

What are the symptoms of central serous choroidopathy?
Symptoms include blurred central vision, small image size (micropsia), and distortion of the image (metamorphosia). After central serous resolves, most patients will still have residual symptoms such as distortion, decreased color and contrast sensitivity, and vision difficulty at night. There is also a 40-50% change of recurrence over time. In some cases, the longterm complications may be due to residual chronic activity and a more detailed evaluation of the disease process may improve the visual results.

What are the causes of central serous choroidopathy?
While there is no definite known cause for this condition, we do know that it usually affects young males between the ages of 20-45. However, women may also be affected. Risk factors for the development of this condition include a “type A personality”, the use of steroids, caffeine or other stimulants (e.g., energy drinks, dietary supplements), as well as smoking, a history of trauma, physical/emotional stress.

What are the treatments for central serous choroidopathy?
While there is no known cure, treatment is directed at the underlying modifiable risk factors such as removal of stimulants from the diet (e.g., smoking, caffeine, energy drinks, steroids) and improved life style (e.g., more sleep = less stress). Normally this condition clears up in a month or two. In patients with more severe vision loss or a prolonged course of the disease, laser treatment has been shown to reduce the course of the disease and improve vision. In some complex cases, we may consider treatment with a “cold laser” (photodynamic therapy with Visudyne), intraocular injections of anti-VEGF drugs such as Avastin, or a combination of these treatments. Non-steroidal anti-inflammatory drugs (NSAIDS) have been shown, experimentally, to stimulate fluid absorption but have not been proven in a controlled clinical trial.