Central serous chorioretinopathy: causes, symptoms, diagnosis, treatment

Central serous chorioretinopathy is a disease manifested by a serous detachment of the neuroepithelium of the retina 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 mechanism in the development of the disease can be stress, and the onset of the disease is due to increased permeability of the Bruch membrane. In the pathogenesis of the disease, great importance is attached to the violation of blood flow velocity and hydrostatic pressure in choriocapillaries, as well as to an increase in the permeability of the walls of the vessels of the choroid. There is no evidence of a hereditary nature of the disease. Central serous chorioretinopathy is widespread throughout the world. Among the diseases prevail in the third to fourth decade of life. The prognosis is favorable, but relapses are often noted.

Symptoms of central serous chorioretinopathy

Patients complain of sudden blurring of vision, the appearance of a dark spot before the eye, a decrease (micropsy) or an increase (macropsia) of objects, a distortion of their shape (metamorphosis) in one eye, a violation of color vision, accommodation. Initial symptoms may not be seen by the patient until the disease manifests in the other eye. In 40-50% of cases, the process is two-sided. The relative safety of visual acuity in the presence of a detachment of pigment epithelium can be explained by the presence of an unclosed neuroepithelium of the retina.

In the early stage of the disease, a focus of an elevated turbid retina with a size of 0.5 to 5 times the diameter of the optic nerve disc appears in the central region. At the edge of the focus, the folding vessels create a rim of the light reflex.

A few weeks later, the origin of the focus decreases, the clouding of the retina disappears. In the place of the hearth there are small yellowish-white spots called precipitates. The visual acuity increases, but co-i is stored relative scotoma in the field of vision. Later, visual acuity is restored, subjective and objective symptoms of the disease disappear, but often the process recurs. After repeated attack of the disease in the macular area, areas of uneven pigmentation remain.

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Diagnosis of central serous chorioretinopathy

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

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Treatment of central serous chorioretinopathy

In most cases, self-healing occurs in a few weeks or months. In view of the alleged etiology of the process, dehydration and anti-inflammatory therapy is carried out, steroids are prescribed; Perform also laser photocoagulation to close defects in pigment epithelium.