The retina sits ontop of a layer called the choroid, which is what supplies most of the retina with oxygen and nutrients. Central serous chorioretinopathy cscr is potentially sightthreatening and has been associated with corticosteroid use. Transfoveal micropulse laser treatment of central serous. Central serous chorioretinopathy is when fluid builds up under the retina. Other causes for rpe leaks, such as choroidal neovascularization, inflammation, or tumors, should be ruled out to make the diagnosis. Central serous chorioretinopathy the american society of. The retina is a thin, sensitive layer of tissue in the back of the eye. Complete ophthalmological examination, last generation oct stratusoct, software version 3. The authors present three cases of chronic central serous retinopathy in which rifampin was used for the utility of its oral delivery in remote care and as an.
Most cases of central serous chorioretinopathy clear up in one or two months without any treatment. When to treat and not to treat patients with central serous. A buildup of fluid results in swelling and raised retinal tissue close to the macula and may result in retinal detachment. Central serous chorioretinopathy csc, the fourth most common nonsurgical retinopathy,1 is defined as serous retinal detachment with or without pigment. Central serous chorioretinopathy fulltext ophthalmologica 2014. Central serous chorioretinopathy is not a frequent disease, but it is important to consider it because it is the forth retinal disease that most threatens our vision behind agerelated macular degeneration, vascular occlusions or diabetic macular edema. The pathogenesis of central serous chorioretinopathy csc.
Central serous chorioretinopathy diagnosis and treatment. For unknown reasons, men develop this condition more commonly than women. Pdf central serous chorioretinopathy cscr is characterised by acute or chronic neurosensory detachments of the retina, usually in the posterior. 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. Central serous chorioretinopathy california 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. Mar 27, 2017 introduction central serous chorioretinopathy csc cscr most popularly known as csr central serous retinopathy is a sporadic disease of unknown etiology characterized by blister like serous detachment of neurosensory retina and retinal pigment epithelium rpe in the posterior pole of the eye. Central serous retinopathy is an eye condition in which fluid builds up behind the retina and affects your vision. The pathogenesis of central serous chorioretinopathy csc is still not fully understood. 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. Central serous retinopathy csr or central serous chorioretinopathy cscr affects the central area of your retina known as the macula. The goal of this study was to examine the outcome of transfoveal subthreshold micropulse laser treatment smplt of cscr performed at six. Serous detachments, with bullous elevation of the retina, occur in a variety of disorders including central serous chorioretinopathy csc, age related macular degeneration, lupus erythematosus, choroidal ischaemic disorders such as accelerated hypertension and preeclampsia, systemic corticosteroid usage, over some choroidal tumours, and in inflammatory disorders such as. Central serous chorioretinopathy nih clinical center.
Central serous chorioretinopathy cscr sankara nethralaya. Csc most often occurs in young and middleaged adults. Recent findings and new physiopathology hypothesis. 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. A healthy macula is about 250 microns one quarter of a millimetre thick. H pylori infection, steroid use, disturbed sleep, autoimmune disease, psychopharmacologic medication use, and type a behavior were among possible risk factors for central serous chorioretinopathy. The effects on the retina are usually selflimited, although some people are left with permanent vision loss due to progressive and irreversible photoreceptor damage. Central serous chorioretinopathy active research protocols.
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. Pdf central serous chorioretinopathy, corticosteroids. Central serous chorioretinopathy the nih clinical center. It typically affects young and middleaged men with no previous medical and family history, and no systemic symptoms or signs. Central serous chorioretinopathy csc is a disease of the retina characterized by serous.
Review and update for central serous chorioretinopathy koreamed. The intended audience includes ophthalmology residents or anyone who would like to brush up on csc. 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 discusses the mechanisms, pathogenesis and risk factors of cscr, findings on various imaging modalities, available treatment options, and translational research into new treatment options for cscr management. Central serous retinopathy csr, also known as idiopathic central serous chorioretinopathy, is a condition in which there is a collection of fluid beneath the center the macula of the retina. On the cause of serous detachments and acute central. 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 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. If this does not revert spontaneously, visual disturbances occur.
Central serous chorioretinopathy cscr is a major cause of vision threat among middleaged male individuals. Sometimes there is severe vision loss or the leakage does not go away. 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. 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. Central serous chorioretinopathy definition of central. Central serous chorioretinopathy free download as powerpoint presentation. Central serous chorioretinopathy and glucocorticoids. The fluid leaks from the choroid the blood vessel layer under the retina.
The fundus autofluorescence pattern of central serous chorioretinopathy is related to the disease chronicity, visual acuity, and optical coherence tomography findings. This results in an elevation of the retina, which affects the vision. The layer of cells between retina and choroid is called the retinal pigment epithelium rpe. It is part 2 of 3 short lectures on central serous chorioretinopathy. Pdf oral medications for central serous chorioretinopathy.
Csr, also known as central serous chorioretinopathy csc, is a visual impairment, often temporary, usually in one eye, mostly affecting males in the age group 20 to 50 but which may also affect women. Central serous chorioretinopathy cscr wills eye hospital. Central serous chorioretinopathy genetic and rare diseases. 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 csc most often occurs in young and middleaged adults. Cscr secondary to steroid use can sometimes be challenging to treat, especially if continuing steroid use is medically necessary. Central serous chorioretinopathy csc is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains ambiguous.
Chorioretinopathy definition of chorioretinopathy by. This is a lecture made for my ophthalmology residents. Central serous chorioretinopathy csc is a common cause of central vision loss, primarily affecting men 2060 years of age. 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 is a relatively common retinal disease characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. Csr is a condition in which fluid collects underneath the retina at the back of the eye. Central serous choroidopathy information mount sinai. The condition has been given various labels, including idiopathic central serous choroidopathy, central serous pigment epitheliopathy, central serous retinopathy yannuzzi 1987 and the currently favoured term, central serous chorioretinopathy. This comprehensive book is written for retina specialists and surgeons, researchers and clinical. Chronic csc is also known as diffuse retinal pigment epitheliopathy. Central serous chorioretinopathy laser treatment for retinal stress burnout disease is treatable. The effects on the retina are usually selflimited, although some people are left. 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. Symptoms of central serous chorioretinopathy can include.
Retinal physician central serous chorioretinopathy. Central serous retinopathy csr is an affliction that can cause vision loss or make objects appear much smaller than they are in actuality. Signs and symptoms include dim and blurred blind spot in the center of vision. 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. Central serous chorioretinopathy csc is an eye disease that causes serous retinal.
Spironolactone for secondary central serous chorioretinopathy. Csr can cause your vision to be blurred and distorted due to fluid collecting underneath your macula. To describe retinal findings in patients with idiopathic central serous chorioretinopathy icsc as assessed by optical coherence tomography oct, and to compare them to fluorescein angiography fa findings. Clinical application of fluorescein angiography free navigated focal laser photocoagulation in central serous chorioretinopathy. Jun 28, 2008 the condition has been given various labels, including idiopathic central serous choroidopathy, central serous pigment epitheliopathy, central serous retinopathy yannuzzi 1987 and the currently favoured term, central serous chorioretinopathy. 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. Classification of fundus autofluorescence patterns in central serous chorioretinopathy is helpful when predicting the disease status and considering the timing of treatment. Exogenous testosterone use and central serous chorioretinopathy. 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. Patients often notice a circular grey patch in their vision. Purchase central serous chorioretinopathy 1st edition. This is the back part of the inner eye that sends sight information to the brain. Pdf central serous chorioretinopathy cscr is a major cause of vision threat among middleaged male individuals. Central serous chorioretinopa thy csc affects roughly 10 men and two women per 100,000 peo.
Ophthalmic complications associated with corticosteroid usage include cataract and glaucoma. Pdf central serous chorioretinopathy csc is a chorioretinal disease. Central serous chorioretinopathy csc is a chorioretinal disease, incompletely understood with systemic associations, a multifactorial aetiology, and a complex pathogenesis. Central serous chorioretinopathy is an eye disease which primarily affects middleaged people. Central serous chorioretinopathy usually affects just one eye at a time, but both eyes can be affected at the same time. In most people, csr gets better on its own and doesnt cause longterm changes to vision. Clinical application of fluorescein angiographyfree.
To investigate the clinical characteristics of central serous chorioretinopathy cscr in the setting of exogenous testosterone use. Fundus and redfree photo of the left eye of a patient with recurrent. To date, no consensus has been reached regarding the classification of csc, and a wide variety of interventions have been proposed, reflecting. It has been recommended that any invasive treatment performed in patients with central serous chorioretinopathy cscr not be initiated earlier than four months after disease onset due to the potential for spontaneous remission of symptoms. Central serous chorioretinopathy 1st edition elsevier. Four teen cases of central serous chorioretinopathy in pregnancy had been reported before this study was conducted. It is a common ocular disease characterized by decompensation of the retinal pigment epithelium rpe, which results in neurosensory retinal detachment, serous pigment epithelium. A 24hour urinary free cortisol can be an initial screening. Corticosteroids have also been implicated in another important cause of visual loss, central serous retinopathy csr1,2, a disorder characterized by. The cause of this condition is unknown but stress can be a risk factor. The fluid leaks from the blood vessel layer under the retina. These cases have suggested a nonwhite predominance. Central serous chorioretinopathy karger publishers.
During this time, your ophthalmologist will look at your eye to see if the liquid is going away. Jul, 2017 central serous chorioretinopathy cscr is potentially sightthreatening and has been associated with corticosteroid use. 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. Jun 07, 2017 central serous retinopathy is an eye condition in which fluid builds up behind the retina and affects your vision. The fluid leakage comes from a layer of tissue under the retina, called the choroid. 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. The disorder is characterized by leakage of fluid in the central macula usually with a blister appearance fig 1, which results. Central serous chorioretinopathy csc is characterized by the accumulation of. Localized serous detachment of the neurosensory retina in the region of the macula without subretinal blood or lipid exudates central serous choroidopathy 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. The purpose of this study was to determine if there is an association between obstructive sleep apnea osa and central serous chorioretinopathy cscr. It is only about 5mm across but is responsible for all of our central vision, most of our colour vision and the fine detail we see. Central serous retinopathy csr is also known as central serous chorioretinopathy or cscr. Central serous choroidopathy is a disease that causes fluid to build up under the retina.
Central serous chorioretinopathy diseases and disorders. Current concepts in managing central serous chorioretinopathy. Central serous chorioretinopathy and pregnancy jama. This is the first of three lecturettes on the topic of central serous chorioretinopathy csc. Subretinal fibrinous exudates have been seen in 90% of the patients, compared with fewer than 20%. Central serous retinopathy csr rnib see differently. Central serous chorioretinopathy csc is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains largely ambiguous.
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