Central serous retinopathy (CSR)

Central serous retinopathy (CSR) or central serous chorioretinopathy (CSCR) affects the central area of your retina known as the macula. CSR can cause your vision to be blurred and distorted due to fluid collecting underneath your macula.

In most people, CSR gets better on its own and doesn’t cause long-term changes to vision. In some people it may re-occur. Episodes of CSR that last for a long time or keep coming back are more likely to cause permanent changes in your vision.

Our downloadable factsheet has more information about CSR:

Download our full guide on CSR (Word, 2.2 MB)

 

How does CSR affect your vision?

The swelling in the macula can cause blurry vision, distortion, blind spots, muted colours and objects appearing smaller than they are. You may also have trouble with bright light and your ability to see an object against a background of similar colour (contrast sensitivity) could be reduced. Some people may find that their vision fluctuates – on some days they may see better and other days not very well at all. For some people, the swelling may not cause any visual symptoms at all.

CSR usually occurs in one eye and can affect men or women. However, it tends to affect mainly young to middle aged men, between 20-45 years old.

What causes CSR?

In most cases, CSR is idiopathic, which means no cause can be found to explain why it occurred. However, several possible risk factors have been identified. The condition seems to occur more frequently in people:

  • with a Type A personality (people who are stressed and find it hard to relax)
  • who use steroid medication
  • during pregnancy
  • with Cushing syndrome.

When you’re under stress, your body releases a natural steroid into your bloodstream called cortisol which helps your body to cope.

Although cortisol is essential for your health, raised levels of cortisol can sometimes cause problems for your body. This can include immune suppression (reducing the body’s ability to fight infection) and increased fragility and permeability of the blood vessels.

Although cortisol is currently thought to be linked to CSR, it is not thought to be solely responsible for the condition and cannot explain all cases of CSR.

In most cases of CSR, the cause is unknown.

What is the outlook?

Generally speaking, the way CSR may progress can be grouped into three categories.

  • Most people will recover within 4-6 months without any need for treatment.
  • CSR which lasts up to 12 months and may require treatment
  • CSR which lasts over 12 months. This is very rare but can lead to further changes such as RPE detachment or bullous retinal detachment.

Treatment isn’t usually needed for CSR. Most people will find that their vision will improve within 3-6 months without the need for treatment.

In a small number of people, CSR can be chronic, lasting longer than 12 months. In these cases, sight is more at risk because the retinal layers at the back of your eye can become damaged from prolonged swelling. As a result, treatment may be recommended for CSR lasting longer than six months.

How is CSR treated?

Most people with CSR don’t require treatment. If treatment is required then thermal laser or photodynamic therapy (PDT) may be used.

When deciding on treatment, the ophthalmologist (hospital eye doctor) would consider:

  • How long you have had CSR, as treatment would only be considered after 4-6 months of the initial diagnosis.
  • If you experience a recurrence, then treatment may be considered sooner.
  • Thermal laser treatment isn’t given if the fluid is leaking too close to the centre of the macula because it could cause more harm than good.

Download our factsheet for more information about CSR and how it is treated

Help to see things better

Most people with CSR find that their vision gets better and they aren’t left with long term changes to vision. However, having chronic CSR can cause changes to your vision in the long term, but much can be done to help you make the most of your remaining vision and adapt to any changes.

If the affected eye was your good eye and you have a sight problem in your other eye, then you may need to make changes or use aids to make the most of your remaining sight. This may mean making things bigger, using brighter lighting or using colour to make things easier to see. We have a series of leaflets with helpful information on living with sight loss, including how to make the most of your sight. You can find out more about our range of titles by contacting our Helpline.

You should ask your ophthalmologist, optometrist or GP about low vision aids and getting a low vision assessment. During this assessment with an optometrist, you’ll be able to discuss the use of magnifiers and aids to help you to see things more clearly.

About this guide

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