CENTRAL SEROUS RETINOPATHY

• Central Serous Chorio Retinopathy (CSCR) is serous retinal detachment at the posterior pole of the eyeball (macula or in the perimacular region) due to a defect in the pigment epithelium
• It is due to a defect in the pigment epithelium that leads to fluid leakage from the sclera into the subretinal space and cause serous retinal detachment 
• CSCR is an idiopathic, self limiting but recurrent condition which occur suddenly, more likely to Men than women in their 30s to 50s. Central Serous Retinopathy does not always produce symptoms and usually affects just one eye at a time

Unknown

Risk factors

• Age and the sex-The disease affects typically young adult (20–50 years), males more than females
• Personality-Type A personality individuals are more prone
• Steroid intake is an important risk factor
• Emotional stress
• Glucocorticoids
• Hypertension
• Pregnancy (usually 3rd trimester)
• Cushing’s disease

Symptoms

• Sudden painless loss of vision (6/9–6/24)
• Relative positive Scotoma, Micropsia and Metamorphopsia
• Distorted, dimmed, or blurred central vision

• A dark area in central vision
• Straight lines may appear bent, crooked or irregular in the affected eye
• Objects may appear smaller or further away

Signs

Bio microscopic Fundus examination reveals:

• Mild elevation of macular area, demarcated by a circular ring reflex
• Small yellow grey elevations may be seen due to RPE detachment
• Foveal reflex is absent or distorted
• Subretinal deposits may be seen
• Multifocal pigmentary changes suggest chronicity

Fundus fluorescein angiography

• Ink-blot pattern
• Smoke-stack pattern

OCT - Fluid collection seen between retinal layers

Opthalmoscopy – Roundish detachment of the central retina

• Conservative measures. Reassurance is the only treatment required in majority of the cases since CSR undergoes spontaneous resolution in 80 to 90% cases
• Laser photocoagulation
• Anti-VEGF
• Lifestyle modifications such as proper sleep, avoid stress etc as these are the key factors

Ayurvedic Treatment

Internal medicines

To relieve fluid collection in the retina

• Punarnavadi kashaya
• Guduchyadi kashaya
• Triphala Gritha
• Dashamoolaarishta
• Punarnavasava
• Vaiswanara choorna

Procedures

• Netra dhara - Triphala+ Erandamoola kashaya
• Jaloukavacharana - forehead
• Sirolepa - Erandamoola + Lodhra +Triphala choorna
• Takradhara - highly beneficial