How Should Central Serous Retinopathy Be Treated?

Central serous retinopathy (CSR) is an affliction that can cause vision loss or make objects appear much smaller than they are in actuality. A buildup of fluid results in swelling and raised retinal tissue close to the macula and may result in retinal detachment. CSR is most commonly diagnosed in men between the ages of 20 and 60, however, it can affect women as well. Most cases of  acute CSR heal on their own, but chronic cases may require special attention. Treatment of CSR comes down to the severity of the case, whether it is chronic (lasting more than six months), or the urgency of vision restoration.

Risks of developing the condition include antihistamine use, type-A personalities, pregnancy, hypertension that has not been treated and other causes of metabolic stress to the retinal pigment epithelium (RPE). Since there are risks involved in any treatment, Francesco Boscia, MD writing for Retina Today, chooses to monitor the condition closely in his patients and treat only in certain cases. Typically, these include chronic conditions, the disease causes changes in the RPE or if the patient’s profession relies heavily on their vision and they must have excellent vision as soon as possible.


Where treatment is indicated, thermal laser was often used for treating CSR however, scar tissue and depressed areas of vision were common results. Clinical trials are proving half-fluence photodynamic therapy to be highly effective, but Dr. Boscia prefers to use reduced-fluence photodynamic therapy until further studies have been completed. The reduced-fluence photodynamic therapy for CSR is proven effective and in one study showed 0 percent damage to the treated eyes compared to 44 percent resulting in some damage with full-fluence.


Treating CSR is largely a decision to be made between doctor and patient. Cases that are monitored using ultra-widefield retinal imaging, may allow for earlier detection of complications due to CSR. Earlier detection means treatment can begin sooner, resulting in better patient outcomes. Visit contact us to advance your practice.