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2 views4 pages

Csr

Uploaded by

Souvik Mukherjee
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Central Serous Retinopathy (CSR)

If you have difficulty reading this leaflet, please ask us to send you a copy in a larger
print size.

If your first language is not English, we can arrange for an interpreter to be available.
Please let us know in advance if you require this service.

What is Central Serous Retinopathy (CSR)?


Central serous retinopathy (CSR) affects the central area of the retina called the
macula, which is responsible for our fine-detail vision and colour perception. In CSR,
the macula becomes separated from the eye tissue behind it and fluid builds up in
the space that is created. This can cause the vision to become blurred and
distorted.
Fundus OCT
Image Scan
showin showin
g the g fluid
macula built
area up
of the under
retina the
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 damage.

Central serous retinopathy is six times more common in men than women, and
most often affects people aged between 20 and 50.

What are the symptoms of CSR?


The symptoms of CSR are:
 Noticing a blurred or missing spot in the central vision
 Straight objects or lines seeming curved (distorted)
 Things may look smaller than usual
 There may be changes in your colour vision
 There may be difficulty adapting to changes in light levels
 Difficulty seeing an object against a background of similar colour
(contrast sensitivity)
 Vision may fluctuate – some days the vision may be better than other
days
 Sometimes there are no visual symptoms at all

What causes CSR?


In most cases, CSR is idiopathic, which means no cause can be found to explain
why it occurred. However, several risk factors have been identified, as 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 (these include steroids in different forms such as
inhalers for asthma, nasal spray for hay fever, steroid cream for eczema and
steroid tablets such as prednisolone)
0753/02/ September 2022 - Ophthalmology Page 1
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 during pregnancy
 with sleep apnoea
 with Cushing Syndrome (an over production of the body’s steroid hormone -
Cortisol)

How is CSR diagnosed?


CSR is diagnosed by an Ophthalmologist (Eye Doctor); this will include taking your
detailed history which includes medical and drug history, a clinical examination of
the eyes and imaging tests.

The imaging test which is carried out in the eye clinic is an Optical Coherence
Tomography (OCT) scan. This is a non-invasive camera-based scan which uses light
waves to take cross- section pictures of the macula (central area of the retina). It is
used to identify the fluid under the retina, along with detailed structural changes
secondary to CSR. This imaging tool is not only useful in making a diagnosis but
also useful to monitor the condition, to see for any changes.

What is the Prognosis?


CSR can be grouped into three categories, by the way it progresses:

 Most people will recover within 3 to 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 retinal pigment epithelial 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 treatment. Vision often returns to how it was
before CSR developed, although some people find gradual small changes to vision
which may continue in the long term. About 30-50 per cent of people will have
another episode of CSR either in the same eye or in the other eye.

How is CSR treated?


Most people with CSR do not require treatment.

Observation - In most cases (85%), the fluid in the retina settles on its own within
3-6 months and needs no specific treatment.

Lifestyle changes - Making some changes to a person’s lifestyle can make a


difference, these include:
 Sleeping for at least 7 hours every night (may help to reduce the risk of
developing central serous retinopathy)
 Reducing overall stress levels, such as through exercise
 Avoiding alcoholic drinks
 Reducing caffeine intake

Currently there is no licensed or NICE (National Institute for Health and Care
Excellence) guidance approved treatment for this condition. Research is
currently being carried out to discover new types of treatment. The treatments
may reduce or resolve the fluid collection under the retina but cannot restore
damaged cells in the retina.
Page 2 of
4
How will I manage with the change in my sight?
How much the CSR will affect your sight varies from person to person. Most people
do not notice any difference unless they cover the eye which is not affected, while
others are very aware of the change all the time. We use both eyes together to see
in 3D (three dimensions), so when one eye is affected, people may find they have
difficulty judging distances. This can lead to feeling clumsy, misjudging steps,
pavements and the position of objects. However, after a few months you may find
that this becomes less of a problem, due to our brains being able to adjust to a new
level of vision and making the eye with good sight the dominant eye. Usually, over
time people find their good eye ‘takes over’ and that tasks that were previously
difficult become easier.

Can changing glasses help manage CSR?


Changing existing glasses or getting new glasses does not help manage CSR, as the
glasses prescription can be different depending on the amount of retinal fluid that
there is. Changing the glasses prescription would only help temporarily; so it is
advisable to wait until the CSR has completely resolved.

Can I still drive?


You may be able to continue driving a car or motorcycle if the vision in your other
eye is unaffected by other eye conditions and you meet the visual requirements
for driving. You are required by law to tell the Driver and Vehicle licensing
Authority (DVLA) if you have any eye conditions which may affect your vision in
both eyes.

Ask your Ophthalmologist or local opticians for advice about whether your sight
meets DVLA standards and whether you can continue driving. Even if you are told
that your sight does meet DVLA standards, you may be advised to wait until you
have adapted to having poorer vision in one eye before you resume driving.

What should I do if I have a problem?


If you develop any of the symptoms featured in this leaflet, or need urgent advice
about your eye(s), you can contact our Eye Emergencies telephone line on 0300
1314 500 extension 771744 (Mondays to Fridays between 09:00am and 5:00pm).
Alternatively you should seek an appointment with your GP or a high-street
optician.

Cancelling your appointment


If you need to cancel or change your appointment, please call the appointments
line on
0300 131 4600.

Your comments
We are always interested to hear your views about our leaflets. If you have any
comments please contact the Patient Experience Team – on 0300 131 4731 or
by email at: esh- tr.patientexperience@nhs.net

Hand hygiene
The trust is committed to maintaining a clean, safe environment. Hand hygiene is
very important in controlling infection. Alcohol gel is widely available for staff use3 of
Page
and at the entrance of each clinical area for visitors to clean their hands before
4 and
after entering.
Other formats
If you require any of the Trust leaflets in alternative formats, such as large
print or alternative languages, please contact the Equality and Human
Rights Department.

Tel: 0300 131 4434 Email: esh-tr.accessibleinformation@nhs.net


After reading this information are there any questions you would like to ask? Please
list below and ask your nurse or doctor.

Sources of information
Moorfields Eye Hospital. 2018. Central Serous Chorio-retinopathy
(CSCR) - www.moorfields.nhs.uk (accessed March 2019)
Macular Society. 2019. Central serous retinopathy.
www.macularsociety.org/central-serous- retinopathy (accessed 4th April 2019)
RNIB. 2018. Central serous retinopathy - www.rnib.org.uk (accessed 4th
April 2019) All the above information can be accessed via the Internet.

Reference
Reviewed by: Paul Russell (Ophthalmology Staff Nurse)

The following clinicians have been consulted and agreed this patient
information:
Mr. Pantelis Ioannidis, Consultant Ophthalmologist, Mr. Kashif Qureshi,
Ophthalmology Consultant, Mr. Saruban Pasu, Ophthalmology Consultant,
Matron Tracy Daniel, Eye Outpatients Bexhill.

The directorate group that have agreed this patient information leaflet:
Ophthalmology Department, Diagnostic, Anaesthetic and Surgery
Next review
division date:
(DAS) September 2025
Responsible Ophthalmology Department
author: (ESHT)
© East Sussex Healthcare NHS Trust -
www.esht.nhs.uk

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