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 inthe macular region of the retina. The macular region of the retina isthe part of the retina responsible for vision. CSR manifests as blurredor distorted vision. Though the exact cause of CSR is not known, manyfactors are known to precipitate it. Steroid use is known to trigger andactivate CSR, and may also cause relapses. Most cases of CSR resolvespontaneously with a favorable visual outcome. Recurrent, persistent orbilateral cases may warrant treatment. Treatment may also be initiatedwhen the patient demands prompt recovery due to exacting visualrequirements at work. There is no known effective treatment for thedisease. Ongoing steroid therapy may be stopped or substituted withother drugs in consultation with the treating physician. Cessation ofsteroid therapy has been known to aid in the resolution of the disease. Laser photocoagulation, which effectively burns the leaking area, is anoption in cases where the leak is away from the central macula (theleaking area is localized by a procedure known as flouresceinangiography). In many cases the leak is very near the central macula,photocoagulation would leave a blind spot and is avoided. Transpupillarythermotherapy and photodynamic therapy has been advocated as alower-risk alternative to laser photocoagulation, especially in caseswhere the leak is in the central macula. Anti-VEGF drug injections havealso been tried in CSR but their role in definitive treatment of thedisease has not been established.Patients are recommended to destress as stress is known to be a majortrigger factor for the disease.