Central Serous Retinopathy

Central Serous Retinopathy | Randall Wong MD

Central Serous Retinopathy

Central serous retinopathy, aka CSR, is a recurrent idiopathic swelling of the retina. The disease usually affects males more often than females ages 25-45. As the patient ages, the time in between episodes gets longer.

The term idiopathic means that scientists have not figured out a cause.

The arrows show the area of accumulated serous fluid.

Patients often complain of blurred vision, poor color perception, minification (objects appear smaller) and distortion.  Onset of symptoms usually occurs rapidly, such as overnight.  

Retinal Swelling

For reasons unknown, fluid develops underneath the layers of the retina.  Symptoms are most noticeable when the macula is involved, in fact, some patients may not be aware of swelling outside of the macular area.  

The disease is commonly known for its association with Type A personalities or stress.  It’s difficult to say, however, how a personality type or stress causes the condition.  

Use of steroids or medications containing steroids may exacerbate the condition in certain patients. 

Evaluation of CSR

Fluid underneath the retina associated with central serous retinopathy can usually be easily seen during a dilated eye examination.

Use of the optical coherence tomography (OCT) and fluorescein angiography are ancillary tests that help clinch the diagnosis.

There is a characteristic “hyperopic shift” where the eye becomes more far-sighted due to the elevation of the retina.  

Symptoms of Central Serous Retinopathy

All the symptoms listed above are common when the macula is involved.  

The fluid causes a separation between the layers of the retina.  A healthy macula normally allows us to see 20/20, read fine print and detail and gives us excellent color perception.

The serous fluid underneath the retina elevates the retina and can cause minification (objects are smaller than the other eye), poor color perception, blurriness and distortion.


There is usually no treatment necessary for CSR patients.  The disease is “self-limited.”  Self-limited diseases usually cause no permanent injury.  In most cases, full vision returns without treatment.  Once in a while, a patient may be left with some slight blurring or distortion.

Laser treatment is reserved for those patients with a “hot-spot” identified by fluorescein angiography that is far enough away from the center of the macula so that the laser burn does not cause a blind spot.  Still, laser treatment is not thought to improve eventual visual outcomes.

Photodynamic therapy (PDT) and intravitreal injections are sometimes helpful.

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