Central Serous Chorioretinopathy (CSCR)

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  • Predominantly men between 30 to 50 years are affected
  • Risk factors: strongly associated with steroids (ask about infiltrations or asthma sprays)


  • Symptoms: Worsening of visual acuity, blurred vision, dyschromatopsia, relative scotomas, metamorphopsia
  • OCT: Subretinal fluid , one/multiple mostly small, circumscribed serous pigment epithelial detachments
  • Fluorescein angiography: Ink blot appearance , smokestack sign, RPE alterations, leakage, granular hyperfluorescences (chronic stage)


  • Stop all steroid therapies
  • Initial observation (spontaneous resorption in 90% within 1-6 months)
  • If subretinal fluid persists for 3-4 months and is visually relevant:
    • Fluorescein angiography (+ICG): hyperfluorescent spots/leakage, smokestack sign?
      • if leakeage extrafoveal (at least 500um from fovea): consider focal laser treatment
      • if leakage central: consider subthreshold laser
      • Note: Data regarding laser therapy not clear, Cave: Risk of secondary CNV
    • Evaluate half-dose Photodynamic Therapy (PDT)
      • Planning based on ICG, FLA, OCT
  • Signs of secondary CNV: anti-VEGF indicated
  • Eplerenone therapy no longer recommended


  • Recurrence in 50%