It is more common in men and typically occurs between the ages of 25 to 50 years. This hypothesis was later supported by studies using indocyanine green angiography icga which showed multifocal areas of choroidal vascular hyperpermeability in eyes with csc. Central serous chorioretinopathy raffael liegl michael w. However, atypical presentations or chronic cases are more of a challenge. New diagnostic tools and new treatment modalities are emerging in order to improve the functional outcomes of these patients.
When to treat and not to treat patients with central serous. The margins of the serous detachment are sloping and merge gradually into the normally attached retina of the posterior pole. This is a lecture made for my ophthalmology residents. The fluid leaks from the blood vessel layer under the retina. He returned approximately 2 years and 8 months later at which time the csc had resolved. Dec 02, 2019 central serous chorioretinopathy csc is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains largely ambiguous. Dec 05, 2014 this is a lecture made for my ophthalmology residents.
The purpose of this study was to determine if there is an association between obstructive sleep apnea osa and central serous chorioretinopathy cscr. Central serous chorioretinopathy linkedin slideshare. Central serous chorioretinopathy cscr is a relatively common cause of visual impairment in the western world, and is characterized by the accumulation of subretinal fluid in the macula. Manual adjustment of the segmentation level at the outer boundary. However, as many as third of the patients have recurrent episodes or chronic disease that may cause significant functional impairment. However, relapsing serous detachments of the neurosensory retina are known to. Central serous chorioretinopathy the american society of retina. Optical coherence tomography angiography compared with. To compare the outcomes of treatment with intravitreal bevacizumab ivb versus observation in central serous chorioretinopathy cscr. Central serous chorioretinopathy csc is a chorioretinal disease, incompletely understood with systemic associations, a multifactorial aetiology, and a complex pathogenesis. Central serous chorioretinopathy retinal capillary angioma.
This leakage leads to a blister, or serous detachment, in the macula that may lead to vision distortions and decreased visual acuity. The common risk factors are psychological stress, type a personality, systemic steroid use, hypertension and pregnancy 35. Central serous chorioretinopathy a thread was started yesterday on this topic, which could be of great importance and interest to pilots. The retina is a thin, sensitive layer of tissue in the back of the eye. Central serous chorioretinopathy, commonly referred to as. Highdose antioxidants for central serous chorioretinopathy. Central serous chorioretinopathy csc, the fourth most common nonsurgical.
Central serous chorioretinopathy csc is a maculopathy typically presenting with relative central scotoma, metamorphopsia, and decreased central vision. Certainly there appears to be cases where improvement has occurred so it is. Central serous chorioretinopathy central serous chorioretinopathy, commonly referred to as csc, is a condition in which fluid accumulates under the retina, causing a serous fluidfilled detachment and vision loss. Central serous retinopathy is an eye condition in which fluid builds up behind the retina and affects your vision. Csc, is a condition in which fluid accumulates under the retina, causing a serous fluidfilled. Central serous chorioretinopathy eye center of texas. The margins of the serous detachment are sloping and merge. Patients with cscr without a history of steroid use or secondary retinal disease were matched based on agegenderbody mass index with control patients and administered the berlin questionnaire to assess for osa risk. Central serous chorioretinopathy cscr is a major cause of vision threat among.
When the disorder is active it is characterized by leakage of fluid under the retina that has a propensity to accumulate under the central macula. Central serous chorioretinopathy central serous chorioretinopathy will have it return. To determine the efficacy of highdose antioxidants in the acute stage of central serous chorioretinopathy csc. Choroidal neovascularization secondary to central serous. When to treat and not to treat patients with central. Jun 07, 2017 central serous retinopathy is an eye condition in which fluid builds up behind the retina and affects your vision.
Current concepts in managing central serous chorioretinopathy. To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy. Ulbig department of ophthalmology, ludwig maximilian university of munich, munich, germany rous retinal detachment typically affecting the posterior pole, particularly the macular region fig. It is part 2 of 3 short lectures on central serous chorioretinopathy. Central serous chorioretinopathy cscr is a disease in which a serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium rpe. Central serous chorioretinopathy csc is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains largely ambiguous. Findings from a 39yearold man patient 19 with acute central serous chorioretinopathy csc. Research into the success of treating central serous retinopathy with avastin is scanty, but the drug is so successful in wet age related macular degeneration, diabetes and vein occlusions, that there is every reason to hope it works in central serous retinopathy as well.
Jul 01, 2017 central serous chorioretinopathy csc is characterized by distorted vision micropsia, metamorphopsia, reduced contrast sensitivity, color desaturation due to a serous detachment of the neurosensory retina associated with leakage at the usually impermeable tight junctions between adjacent retinal pigment epithelial rpe cells. Combining these facts, the primary hypothesis was that glucocorticoids could. Atypical vitelliform macular dystrophy misdiagnosed as. The cause of this condition is unknown but stress can be a risk factor. Diagnosing and managing central serous chorioretinopathy. Central serous chorioretinopathy csc is a disorder characterized by serous retinal detachment with or without retinal pigment epithelial rpe.
Central serous chorioretinopathy 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. Pdf anxiety and central serous chorioretinopathy dove. The effects on the retina are usually selflimited, although some people are left with permanent vision loss due to progressive and irreversible photoreceptor damage or retinal. Central serous chorioretinopathy csc is a common retina disease. Due to its ability to overlay icg angiographies and fa images for precise planning, navilas provides a unique and advanced treatment paradigm for central serous chorioretinopathy. The fluid leaks from the choroid the blood vessel layer under the retina. Multimodal imaging led to the description of a wide range of cscr manifestations, and highlighted the contribution of the choroid and pigment epithelium in cscr pathogenesis. Benita tailor optometry intern slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. In most people, csr gets better on its own and doesnt cause longterm changes to vision.
For unknown reasons, men develop this condition more commonly than women. Jun 18, 2019 central serous chorioretinopathy cscr is a disease in which a serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium rpe. Retinal physician update on central serous chorioretinopathy. Central serous chorioretinopathy is an eye disease which primarily affects middleaged people. Central serous retinopathy csr rnib see differently. Increased permeability from the choriocapillaris leads to focal or diffuse dysfunction of the retinal pigment epithelium causing a detachment of the neurosensory retina. I have a patient with a typical presentation of idiopathic central serous retinopathy. Central serous chorioretinopathy csc is an idiopathic disorder.
Lowdose as pirin as treatment for central serous chorioretinopathy. Central serous chorioretinopathy also referred to as central serous retinopathy, but more appropriately termed a chorioretinopathy is a condition characterized by a serous macular detachment due to a focal disruption in the outer bloodretinal barrier. This is because longterm fluid accumulation can lead to permanent vision loss. Optical coherence tomography imaging of macular oedema george trichonas, peter k kaiser cole eye institute, cleveland. This is the back part of the inner eye that sends sight information to the brain. Retinal physician central serous chorioretinopathy. The patients with acute csc onset within 6 weeks were randomized to receive either highdose antioxidant tablets study group a or placebo tablets control group b for 3 months or until the complete resolution of subretinal fluid. Csc most often occurs in young and middleaged adults.
Central serous retinopathy csr or central serous chorioretinopathy cscr affects the central area of your retina known as the macula. Central serous chorioretinopathy cscr is considered a benign, selflimiting disease. Central serous retinopathy csr, also known as central serous chorioretinopathy csc or cscr, is an eye disease that causes visual impairment, often temporary, usually in one eye. Orthogonal registration and the merging of 2 consecutive image sets were. Central serous choroidopathy information mount sinai. Intravitreal bevacizumab for treatment of central serous. Treatment of central serous chorioretinopathy medcraveonline.
It is common in patients between the ages of 3050 years and affects males more often than females with a ratio of 2. Central serous assessing anxiety in patients with cscr was the key focus chorioretinopathy and risk for obstructive sleep apnea. Jan 30, 2014 central serous chorioretinopathy 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. Morphologic changes in acute central serous chorioretinopathy.
Central serous chorioretinopathy csc is a common retina disease and has a. Jul 07, 2014 central serous chorioretinopathy cscr is a relatively common cause of visual impairment in the western world, and is characterized by the accumulation of subretinal fluid in the macula. Csr can cause your vision to be blurred and distorted due to fluid collecting underneath your macula. Central serous chorioretinopathy laser treatment for retinal stress burnout disease is treatable. A, fluorescein angiography fa from a csc episode 1. If this does not revert spontaneously, visual disturbances occur.
Central serous chorioretinopathy cscr is often a straightforward clinical diagnosis when it presents as a typical serous neurosensory retinal detachment in a middleaged male. Central serous chorioretinopathy csc primarily affects middleaged men. The exact underlying mechanism of that disease was not known in. Central serous chorioretinopathy usually affects just one eye at a time, but both eyes can be affected at the same time. Although it is generally selflimiting and unlikely to be of great harm in the longer term, it would certainly be very worrying to most people in a profession to whom eyes and vision are so very important. The layer of cells between retina and choroid is called the retinal pigment epithelium rpe. Central serous chorioretinopathy cscr is a major cause of vision threat among middleaged male individuals. It is a common ocular disease characterized by decompensation of the retinal pigment epithelium rpe, which results in neurosensory retinal detachment, serous pigment epithelium. Central serous chorioretinopathy is when fluid builds up under the retina. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the. Besada e 2016 comparative tomography of central serous 2 chorioretinopathy ne ront phthalmol, 2016 doi. Essentially, it is an idiopathic disorder which means that the precise cause is unknown. Gass in 1967 named the disease as central serous chorioretinopathy and proposed choriocapillaris hyperpermeability as the cause of csc gass 1967. Most patients have a blurred spot in the center of vision.
Central serous chorioretinopathy cscr, also known as central serous retinopathy or csr, is a condition that usually affects younger people and is characterized by a buildup of fluid underneath the retina. Central serous choroidopathy is a disease that causes fluid to build up under the retina. Summary central serous chorioretinopathy is when fluid builds up under the retina. Association of choroidal neovascularization and central serous. Feb 05, 2018 relief of chronic central serous chorioretinopathy using navigated microsecond pulse laser therapy duration. Optical coherence tomography imaging of macular oedema. Choroidal neovascularization, either idiopathic or from histoplasmosis, can have a very similar appearance to idiopathic central serous chorioretinopathy. Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Fluid leaks from the blood vessel layer under the retina called the choroid. Central serous chorioretinopathy genetic and rare diseases. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Central serous chorioretinopathy cscr is a condition that causes fluid to build up underneath the center of the retina macula. Central serous chorioretinopathy, commonly referred to as csc, is a condition in which fluid accumulates under the retina, causing a serous fluidfilled detachment and vision loss. Central serous chorioretinopathy the american society of.
Benita tailor optometry intern slideshare uses cookies to improve functionality and performance, and to. Comparative tomography of central serous 2 chorioretinopathy. Central serous chorioretinopathy csc is a sometimestemporary visual impairment that is characterized by leakage of fluid in the center of the retina. Signs and symptoms include dim and blurred blind spot in the center of vision. Central serous chorioretinopathy introducing an optimized treatment paradigm. Jul 01, 2012 update on central serous chorioretinopathy among other findings, reducefluence and lowdose pdt look promising. Relief of chronic central serous chorioretinopathy using navigated microsecond pulse laser therapy duration. Central serous chorioretinopathy csc is a disorder characterized by serous retinal detachment andor retinal pigment epithelial rpe detachment, changes most often confined to the macula, and associated with leakage of fluid through the rpe into the subretinal space. Central serous chorioretinopathy csc is a serous neurosensory detachment that usually involves the macular area. The retina sits ontop of a layer called the choroid, which is what supplies most of the retina with oxygen and nutrients.
Combining the two methods of autofluorescence imaging, swfaf and nirfaf. The fluid leakage comes from a layer of tissue under the retina, called the choroid. Central serous chorioretinopa thy csc affects roughly 10 men and two women per 100,000 peo ple, and they are often younger, workingaged in dividuals. Central serous is associated with an elevation detachment of the macula due to leakage of fluid from the circulation behind it choroidal circulation. Other causes for rpe leaks, such as choroidal neovascularization, inflammation, or tumors, should be ruled out to make the diagnosis.
It is a common ocular disease characterized by decompensation of the retinal pigment epithelium rpe, which results in neurosensory retinal detachment, serous pigment epithelium detachment ped, and rpe atrophy. Central serous chorioretinopathy csc is a disease of the retina characterized by serous detachment of the neurosensory retina secondary to one or more focal lesions of the retinal pigment epithelium rpe. Nov 23, 2016 gass in 1967 named the disease as central serous chorioretinopathy and proposed choriocapillaris hyperpermeability as the cause of csc gass 1967. A buildup of fluid results in swelling and raised retinal tissue close to the macula and may result in retinal detachment. Central serous chorioretinopathy complicating systemic corticosteroid treatment. The various terms later used to describe the disease, including the current acceptable term cscr first used by gass in 1967, have omitted the relapsing characteristic from the term.
This article is from february 2006 and may contain outdated material. Central serous chorioretinopathy csc is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains ambiguous. Central serous chorioretinopathy cscr wills eye hospital. Central serous chorioretinopathy is a retinal disorder which affects the macula. He is a 45yearold male with sudden vision loss to 2030 and a serous macular detachment. Treating chronic central serous chorioretinopathy retina today. Central serous retinopathy csr is an affliction that can cause vision loss or make objects appear much smaller than they are in actuality. Central serous retinopathy csr is a pathologic condition characterized by swelling and elevation of retinal tissue near the macula due to accumulation of fluid between the photoreceptor outer segments and the retinal pigment epithelium rpe, often leading to detachment of the neurosensory retina. Symptoms of central serous chorioretinopathy can include. Update on central serous chorioretinopathy among other findings, reducefluence and lowdose pdt look promising. It involves the collection of fluid under the retina. Psychosomatic aspects in patients with central serous. Apr 16, 2019 central serous chorioretinopathy csc is a disorder characterized by serous retinal detachment with or without retinal pigment epithelial rpe detachment, and associated with hyperpermeability.
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