Central serous chorioretinopathy: causes, symptoms, diagnosis, treatment

Central serous chorioretinopathy is a disease characterized by serous detachment of the retinal neuroepithelium and/or pigment epithelium. It has been established that serous detachment can be idiopathic, as well as caused by inflammatory and ischemic processes.

The trigger for the development of the disease may be stress, and the onset of the disease is due to increased permeability of the Bruch membrane. In this case, in the pathogenesis of the disease, great importance is attached to the violation of the blood flow rate and hydrostatic pressure in the choriocapillaries, as well as to the increase in the permeability of the walls of the vessels of the choroid. There is no evidence of the hereditary nature of the disease. Central serous chorioretinopathy is widespread throughout the world. Among those affected, men in the third - fourth decade of life predominate. The prognosis is favorable, but relapses are often noted.

Symptoms of central serous chorioretinopathy

Patients complain of sudden blurred vision, the appearance of a dark spot in front of the eye, a decrease (micropsia) or increase (macropsia) in objects, distortion of their shape (metamorphopsia) in one eye, impaired color vision, accommodation. The initial symptoms may not be noticed by the patient until the disease manifests itself in the other eye. In 40-50% of cases, the process is bilateral. Relative preservation of visual acuity in the presence of detachment of the pigment epithelium can be explained by the presence of non-detached retinal neuroepithelium.

In the early stage of the disease, a focus of raised cloudy retina appears in the central section, measuring from 0.5 to 5 diameters of the optic nerve disk. Along the edge of the focus, bending vessels create a rim of light reflex.

After a few weeks, the prominence of the lesion decreases, and the retinal opacity disappears. Small yellowish-white spots called precipitates remain at the site of the lesion. Visual acuity increases, but relative scotoma remains in the visual field. Later, visual acuity is restored, subjective and objective symptoms of the disease disappear, but the process often recurs. After a repeated attack of the disease, areas of uneven pigmentation remain in the macular region.

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Diagnosis of central serous chorioretinopathy

The diagnosis is confirmed by the results of fluorescein angiography: one or more defects in the pigment epithelium are revealed, through which the dye passes into the subepithelial and subretinal space.

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Treatment of central serous chorioretinopathy

In most cases, spontaneous healing occurs within a few weeks or months. Depending on the suspected etiology of the process, dehydration and anti-inflammatory therapy are administered, steroids are prescribed; laser photocoagulation is also performed to close defects in the pigment epithelium.