Central serous choroidopathy is a condition where fluid builds up under the retina, causing it to detach from the back of the eye. It occurs when fluid leaks from blood vessels in the choroid layer under the retina. The cause is unknown but stress appears to be a risk factor. Symptoms include blurred or distorted vision that can sometimes be corrected with glasses. Imaging tests can detect fluid accumulation and leakage sites, and most cases resolve on their own within a few months. Treatment may include laser therapy or anti-VEGF drugs to seal leaks if symptoms persist or vision loss is severe.

2. Prepared by Saba Kausar

3.  Localized serous detachment of the neurosensory
retina in the region of the macula without
subretinal blood or lipid exudates
 Central serous choroidopathy is a disease
that causes fluid to build up under the
retina, the back part of the inner eye that
sends sight information to the brain. The
fluid leaks from the blood vessel layer under
the retina. This area is called the choroid.

5.  The cause of this condition is unknown.
 Incidence: 5-6 per 100,000 people. M:F 6:1
 Men are affected more often than women, and
the condition is most common at around age 45,
but anyone can be affected.
 Stress appears to be a risk factor. Early studies
found that people with aggressive, "type A"
personalities who are under a lot of stress may
be more likely to develop central serous
retinopathy.
 The condition can also occur as a complication of
steroid drug use cushing’s sndrome,systemic
lupus erythematosus, pregnancy.

6.  Sudden onset of unilateral painlesss vision
associated with positive scotoma.
 Visual acuity is reduced 6/9 – 6/18 ,often
correctable 6/6 with weak ‘plus’ lens due to
elevation of the sensory retina gives rise to an
acquired hypermetropia.
 Distortion of straight lines with the affected eye
(metamorphopsia)
 Objects appearing smaller or farther away with
the affected eye(micropsia)
 color desaturation (dyschromatopsia),dec. of
contrast sensitivity
 impaired dark adaptation
 delayed retinal recovery time to bright light

7.  Retinoscopy show hypermetropia due to
elevation of retina.
 Fundus examination shows;
• Oval or around elevation of sensory retina of
macular area demarcated by circular ring
reflex.
• Foveal reflex is absent or distorted.

8.  Amsler grid test: For confirmation of
metamorphopsia.
 ICG angiography : has demonstrated both
multifocal choroidal hyperpermeability and
hyperfluorescent areas suggestive of focal
choroidal vascular compromise.
 Optical Coherence Tomography (OCT):optically
empty neurosensory elevation. A RPE
detachment.

10.  Ink :
A small hyperflourescent spot increases in
size gradually is a most common present.
 Smoke:
stack pattern a small hyperflourescent spot
ascends vertically like a smokstack and
gradually spreads laterally to take mashroom
or umbrella configuration
 Multiple leak pattern :
more than one leak may be present at the
posterior pole.

14.  Most cases clear up without treatment in 1 or 2
months. Patients with more severe leakage and
more severe visual loss, or those in whom the
disease lasts longer, may be helped by laser
treatment or photodynamic therapy to seal the
leak and attempt to restore vision.
 Intraviteral anti- VEGF used showing good
results.
 Patients who are using steroid drugs (for
example, to treat autoimmune diseases) should
stop using them, if possible. Any change in
steroid drug use in these conditions must be
under the supervision of a physician