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How can central serous retinopathy be treated?

Q: My 41 years old wife has been suffering from asthma for the past ten years. Suddenly she encountered a blurred vision in her left eye. Central serous retinopathy (CSR) was diagnosed due to steroids being taken by her to control asthma. It has recurred after a gap of two years. Is there a treatment for central serous retinopathy?

A:Central serous retinopathy (CSR) occurs due to accumulation of fluid in the macular region of the retina. The macular region of the retina is the part of the retina responsible for vision. CSR manifests as blurred or distorted vision. Though the exact cause of CSR is not known, many factors are known to precipitate it. Steroid use is known to trigger and activate CSR, and may also cause relapses. Most cases of CSR resolve spontaneously with a favorable visual outcome. Recurrent, persistent or bilateral cases may warrant treatment. Treatment may also be initiated when the patient demands prompt recovery due to exacting visual requirements at work. There is no known effective treatment for the disease. Ongoing steroid therapy may be stopped or substituted with other drugs in consultation with the treating physician. Cessation of steroid therapy has been known to aid in the resolution of the disease. Laser photocoagulation, which effectively burns the leaking area, is an option in cases where the leak is away from the central macula (the leaking area is localized by a procedure known as flourescein angiography). In many cases the leak is very near the central macula, photocoagulation would leave a blind spot and is avoided. Transpupillary thermotherapy and photodynamic therapy has been advocated as a lower-risk alternative to laser photocoagulation, especially in cases where the leak is in the central macula. Anti-VEGF drug injections have also been tried in CSR but their role in definitive treatment of the disease has not been established. Patients are recommended to destress as stress is known to be a major trigger factor for the disease.


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