The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

Skip to main content

Central Serous Chorioretinopathy

Idiopathic neurosensory retinal detachment associated with corticosteroid exposure and stress

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Central Serous Chorioretinopathy?

Central serous chorioretinopathy is the fourth most common non-surgical retinopathy following age-related macular degeneration, diabetic retinopathy, and retinal vein occlusion, with an estimated incidence of 9.9 per 100,000 in men and 1.7 per 100,000 in women. The pathophysiology involves choroidal hyperpermeability with diffuse choroidal vasodilation, retinal pigment epithelium (RPE) dysfunction with focal leaks, and accumulation of serous fluid between the neurosensory retina and RPE, classically at the posterior pole.

Risk factors include male gender (predominantly aged 30-50), type-A personality, psychological stress, exogenous corticosteroid exposure (oral, topical, inhaled, intra-articular, even nasal sprays), endogenous hypercortisolism (Cushing's syndrome, pregnancy), sympathetic activity excess, hypertension, sleep apnea, helicobacter pylori infection, and genetic susceptibility (CFH, ARMS2 polymorphisms). Clinical features include sudden unilateral central scotoma, metamorphopsia, micropsia, decreased contrast sensitivity, dyschromatopsia, and reduced visual acuity (typically 20/30-20/100), with characteristic OCT findings of subretinal fluid and pigment epithelial detachments.

Acute CSC typically resolves spontaneously within 3-6 months in 80-90% of cases. Chronic CSC (>6 months) and recurrent CSC may cause progressive RPE atrophy, photoreceptor loss, and irreversible visual decline. Complications include macular atrophy, choroidal neovascularization (CNV), polypoidal choroidal vasculopathy, and bullous retinal detachment. Treatment options include observation for acute cases, photodynamic therapy (PDT), micropulse subthreshold laser, focal photocoagulation, eplerenone (mineralocorticoid antagonist), and corticosteroid discontinuation.

Symptoms

Sudden unilateral central scotoma
Metamorphopsia (distorted vision)
Micropsia (objects appearing smaller)
Decreased contrast sensitivity
Dyschromatopsia (color desaturation)
Reduced visual acuity (20/30-20/100)
Central blurred vision
Difficulty reading
Hyperopic shift in refraction
Photophobia
Visual fatigue
Bilateral involvement (in chronic cases)
Recurrent episodes
Visual function fluctuation
Subretinal fluid on examination
Pigment epithelial detachment
Subretinal precipitates
RPE atrophy in chronic cases
Choroidal thickening (pachychoroid)
Stress-related onset

Risk Factors

Male gender (5-10x more common than women)
Age 30-50 years
Type-A personality
Psychological stress
Corticosteroid use (oral, topical, inhaled, nasal, intra-articular)
Endogenous hypercortisolism (Cushing's syndrome)
Pregnancy
Hypertension
Obstructive sleep apnea
Helicobacter pylori infection
Sympathetic nervous system overactivity
Pachychoroid disease spectrum
Genetic susceptibility (CFH, ARMS2)
Asian ethnicity
Sleep deprivation
Shift work
Excessive caffeine consumption
Smoking
Sildenafil (PDE5 inhibitor) use
Family history of CSC

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden central vision changes
  • Metamorphopsia or distorted vision
  • Recent corticosteroid use with vision changes
  • Acute decrease in visual acuity
  • Central scotoma
  • Stress-related vision symptoms
  • Recurrent episodes of central vision changes
  • Bilateral central vision changes
  • Worsening of chronic CSC
  • Type-A personality with vision concerns
  • Pregnancy-related vision changes
  • Cushing's syndrome with eye symptoms
  • Treatment evaluation for chronic CSC

Treatment Methods

01
Comprehensive ophthalmologic evaluation by retina specialist
02
Detailed history of corticosteroid use, stress, sleep apnea
03
Visual acuity, contrast sensitivity, color vision testing
04
Slit lamp biomicroscopy and dilated fundus examination
05
Optical coherence tomography (OCT) for subretinal fluid quantification
06
Fluorescein angiography to identify leaks
07
Indocyanine green angiography for choroidal vasculature
08
Fundus autofluorescence for RPE assessment
09
Discontinue or minimize corticosteroid exposure
10
Stress reduction strategies and psychological support
11
Sleep apnea evaluation and treatment
12
Helicobacter pylori testing and eradication if positive
13
Observation for acute cases (resolution in 3-6 months)
14
Photodynamic therapy (PDT) with verteporfin (gold standard for chronic CSC)
15
Half-dose or half-fluence PDT to reduce side effects
16
Subthreshold micropulse laser therapy
17
Focal laser photocoagulation for extrafoveal leaks
18
Eplerenone (mineralocorticoid antagonist) trial
19
Spironolactone alternative
20
Anti-VEGF therapy if choroidal neovascularization develops
21
Acetazolamide for symptomatic relief in selected cases
22
Aspirin trial in selected patients
23
Regular OCT monitoring during treatment
24
Visual function reassessment at intervals
25
Treatment of underlying medical conditions
26
Patient counseling on prognosis and recurrence risk
27
Long-term ophthalmologic follow-up
28
Multidisciplinary management with primary care, endocrinology
29
Genetic counseling in familial cases
30
Quality-of-life assessment and support

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.