Summary

Central serous retinopathy (CSR) is an idiopathic disorder involving a localised serous detachment of the sensory retina at the macula due to leakage from the choriocapillaris through sites of increased permeability on the retinal pigment epithelium (RPE).

Background

Central serous retinopathy (CSR) is an idiopathic disorder involving a localised serous detachment of the sensory retina at the macula due to leakage from the choriocapillaris through sites of increased permeability on the retinal pigment epithelium (RPE).

There are two forms of CSR:

1. Acute: lasting 3-6 months, then self-resolving, with return to near-normal or normal vision. This occurs in 〜80% of patients. Recurrence is seen in up to 1/2 of patients
2. Chronic: 〜15% of patients have chronic CSR lasting ≥12 months

CSR is the 4th most common retinopathy after age-related macular degeneration, diabetic retinopathy, and branch retinal vein occlusion.

Epidemiology

CSR is typically unilateral, affecting males more than females (with a 3:1 male to female ratio), of young-to-middle age (in their 20s to 50s). Females with CSR tend to be older.

Many risk factors for CSR and associations have been proposed, importantly:

• A single nucleotide polymorphism (SNP) on chromosome 1 involving the compliment factor H confers a predisposition to the chronic form of CSR in white patients.
• Steroids (both endogenous and exogenous), including Cushing’s syndrome, have the strongest known association with CSR
• Helicobacter pylori infection
• Renal dialysis
• Hypertension
• Psychological stress
• Pregnancy

Clinical features