Central Serous Choroidopathy (central serous retinopathy)

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Central Serous Choroidopathy (CSC) (also referred to as "Central Serous Retinopathy") is most often seen in young men, aged 20-50. Symptoms may include a fairly sudden onset of blurry vision in one eye, dimmer colors, images seem in miniature or a blind spot in the center of vision. The disorder is characterized by fluid leaking from tissues behind the retina into mostly the central macula area, resulting in detaching the macula from the tissue that supports it. The leakage comes mostly from the choroid layer due to small breaks in the retinal pigment layer (RPE). CSC/CSR patients typically have vision in the 20/20 to 20/100 range and a serous. Sometimes a fluorescein angiogram is used to confirm the diagnosis.

Self Help & Tips

Symptoms

  • A blurry, dim blind spot in the vision center
  • Objects appearing in miniature with the affected eye
  • Distortion of straight lines, as similar to macular degeneration's distortions
CSC/CSR

Causes

  • Stress. Most patients are young men (20-45) with aggressive "type A" personalities. Stress or trauma - both physical and emotional - appears to be an important risk factor. Researchers find that CSR patients have a higher stress scores.4
  • Stimulants Steroid drug use, smoking, caffeine and other stimulants may be a cause.
  • Homocysteine. Researchers find that CSR patients have high homocystein blood levels.4
  • Cortisol. The condition is also associated with high levels of the hormone cortisol, secreted by the adrenal cortex, that helps the body cope with stress. This is true of both morning and evening blood cortisol levels.4 High levels of cortisol characterize Cushing's syndrome, and research has found that 5% of Cushing's patients have CSR.
  • High blood pressure. CSR patients have diastolic and systolic blood pressure levels that are higher than normal.4
  • Steroids. Extensive research has indicated that corticosteroids, such as cortisone, which is prescribed for inflammation, skin conditions, allergies and sometimes eye problems can trigger CSC, make it worse, and/or cause relapses.
  • Helicobacter pylori. There is evidence that this bacteria, a naturally occurringoccurring bacteria in the body, but prevalent in cases of gastritis plays a role.
  • Kidney disease/ Patients with type II kidney disease (MPGN) can develop a variety of retina problems including CSR due to the same accumulated deposits that damaged the kidney membranes.
  • The cause of the condition is unproven, but the above are some likely candidates.

Conventional Treatment

Most cases clear up without treatment in 1 or 2 months. Patients with more severe leakage and more severe visual loss or longer persistence of disease may be helped by laser treatment to seal the leak.

Patients who are using steroid drugs (for example, to treat autoimmune diseases) should discontinue their use if medically feasible. Any change in steroid drug use in these conditions MUST be under the supervision of a physician.

A small number of patients will have complications of laser treatment (laser photocoagulation or hot laser) which impair central vision, which is why most patients will be allowed to recover without treatment.

Cold laser (transpupillary thermotherapy) is said to be a lower risk alternative to hot laser, and photodynamic therapy has also shown some promise.

Complementary Treatment

In a small study researchers found that treatment of CSR patients with melatonin benefited both vision acuity and the density of the macular pigment.1

Certain nutrients such as zeaxanthin, lutein, l-lysine, vinpocetine, specific vitamins & enzymes, and fish oil may help support remaining vision for those suffering from Central Serous Choroidopathy.

Researchers found that although blood levels of lutein improved in CSR patients treated with 20mg daily, macular pigment density did not - however, the condition remained stable while in the control patients given placebo, macular pigment density continued to thin.2 Another study treating CSR patients with high dose antioxidants found similar results, little improvement, but no worsening of the condition.3

Our vision wellness recommendations. See these essential vision tips as the foundation for your good vision.

Daily juicing of vegetables and fruits (preferably organic). Our recipe for this condition is some combination of the following: ginger, garlic, leeks, parsley, beets, cabbage, carrots, celery, spinach, kale, collard greens, apples, grapes, raspberries, lemon, chlorophyll, wheat grasses - (not too much fruit). See more info on juicing.

I would like to thank you for all the supplements you suggested. I faithfully took each one and I prayed and I also consulted with a holistic doctor near me who gave me Ayurveda supplements and had me bathe my eye in Ghee twice a day. I went back to Dr. Brod, the retina specialist here in Lancaster, PA and I am healed. He was so confused because he told me that my eye would never improve, only get worse. He started questioning his original diagnosis because he was shocked that I can now see and that the image of my macula was normal. ... Thank you very much for all you have done for me!
S.R.

Related Conditions

  • Macular degeneration
  • Diabetic retinopathy
  • Posterior vitreous detachment
  • Hypertensive retinopathy - high blood pressure can cause damage to the retina
  • Cushing's syndrome - high levels of cortisol in the blood (can be due to prolonged cortisoid medication use) which affects the adrenal gland. It can give rise to high intraocular pressure, protrusion of the eyeball, or to steroid induced cataracts.

CSR News

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Find Vitamins & Supplements to Support the Retina

Research

Although the underlying physiological cause may be unique, there may be similarities in terms of nutritional, diet and lifestyle recommendations made by Dr. Grossman for eye conditions (such as macular degeneration) that result in similar vision symptoms.

Footnotes

1. A. J. Gramajo, G. E. Marquez, et al., Therapeutic benefit of melatonin in refractory central serous chorioretinopathy, Eye, August, 2015.
2. M. Sawa, F. Gomi, et al., Effects of a lutein supplement on the plasma lutein concentration and macular pigment in patients with central serous chorioretinopathy, Investigative Ophthalmology & Visual Science, July, 2014.
3. M. Ratanasukon, et al., High-dose antioxidants for central serous chorioretinopathy; the randomized placebo-controlled study, BMC Ophthalmology, July, 2012.
4. A. Agarwal, G. Garg, et al., Evaluation and correlation of stress scores with blood pressure, endogenous cortisol levels, and homocysteine levels in patients with central serous chorioretinopathy and comparison with age-matched controls, Indian Journal of Ophthalmology, November, 2016.