CSR

Question 1

What is Central Serous Retinopathy (CSR) also called?

Answer 1

Central serous choroidal retinopathy.

Question 2

What is Central Serous Retinopathy?

Answer 2

An exudative detachment of the sensory retina in the macula area.

Question 3

What is the pathogenesis of CSR?

Answer 3

Poorly understood, Multiple leaks in extrafoveal RPE, FA ‘smoke stack’ or ‘ink blot’ appearance, Active choroidal leakage (ICG), Impaired choroidal circulation.

Question 4

What are the key symptoms of CSR?

Answer 4

Sudden onset reduced VA/blurring, Hyperopic shift due to elevation of retina, Positive scotoma, Metamorphopsia, Micropsia.

Question 5

What is the typical visual acuity range in CSR?

Answer 5

VA between 6/9 to 6/18.

Question 6

What are the clinical features of acute CSR?

Answer 6

Detachment of sensory retina with serous fluid between RPE and photoreceptor outer segments, Oval/round shallow elevation, Absent/attenuated foveal reflex, Pigment changes, PED.

Question 7

What percentage of CSR patients will experience recurrence within a year?

Answer 7

Around 30%.

Question 8

What are the clinical features of chronic CSR?

Answer 8

RPE atrophy, Risk of CNV.

Question 9

How can CSR be differentiated from wet AMD?

Answer 9

Based on age of onset and progression.

Question 10

What is the general management approach for CSR in optometry?

Answer 10

Reassure patient, CSR resolves in 2-3 months, VA recovers in 90% of patients, Subtle metamorphopsia may persist.

Question 11

When should an optometrist refer a CSR patient to an ophthalmologist?

Answer 11

If CSR does not resolve or for further diagnosis confirmation.

Question 12

What is the ophthalmological management of CSR?

Answer 12

Confirmation of diagnosis, Observation, Tapering of systemic steroids.

Question 13

What treatments may be considered for CSR in ophthalmology?

Answer 13

PDT, Focal laser, Anti-VEGF (potentially).

Question 14

Does PDT or focal laser affect visual outcomes in CSR?

Answer 14

These treatments hasten resolution but do not affect the visual outcome.

Question 15

What is the prognosis for recurrent or chronic CSR?

Answer 15

Guarded, especially if recurrent or chronic.

Question 16

What imaging techniques are used to diagnose CSR?

Answer 16

Fluorescein angiography (FA), Indocyanine green angiography (ICG).

Question 17

What characteristic appearance is seen on FA in CSR?

Answer 17

‘Smoke stack’ or ‘ink blot’ appearance.

Question 18

What can chronic CSR lead to if left untreated?

Answer 18

RPE atrophy, Risk of CNV.

Question 19

What is a potential complication of systemic steroid use in CSR patients?

Answer 19

Tapering may be necessary as steroids can exacerbate CSR.

Question 20

What percentage of CSR patients recover their visual acuity?

Answer 20

Approximately 90%.

Question 21

What is Central Serous Retinopathy (CSR)?

Answer 21

CSR is characterised by unilateral, localised detachment of the sensory retina at the macula due to fluid accumulation, with or without associated RPE detachment.

Question 22

Who is typically affected by CSR?

Answer 22

CSR typically affects middle-aged men with a Type A personality.

Question 23

What are the characteristics of a Type A personality?

Answer 23

Competitive, Work obsessed, Stressed, Impatient, No sense of satisfaction in achievements.

Question 24

What are the common symptoms of CSR?

Answer 24

Unilateral blurred vision, Central vision distortion, Scotoma (thumb print/shadow in vision).

Question 25

What is a common visual acuity range in CSR?

Answer 25

Visual acuity typically ranges between 6/9 and 6/12.

Question 26

What is a common refractive shift seen in CSR?

Answer 26

A hyperopic (farsighted) shift in the refractive error.

Question 27

What sign is seen on an Amsler grid in CSR?

Answer 27

Distortion of the grid lines.

Question 28

What is a key sign of CSR seen on OCT?

Answer 28

Subretinal fluid and RPE elevation, best visualized on OCT.

Question 29

What does the elevated area surrounding the macula look like in CSR?

Answer 29

It appears dome-shaped and elevated, often with a yellowish ring around the macula.

Question 30

How long does CSR typically take to resolve?

Answer 30

CSR usually resolves on its own within 2-3 months.

Question 31

What is the initial management approach for CSR?

Answer 31

Monitor the condition, as it tends to resolve spontaneously.

Question 32

When should a CSR patient be referred to an ophthalmologist?

Answer 32

Routine referral to HES is recommended for CSR patients.

Question 33

What is a treatment option to stimulate reabsorption of fluid in CSR?

Answer 33

Argon laser photocoagulation.

Question 34

How can Anti-VEGF therapy help in CSR management?

Answer 34

Anti-VEGF may be used to reduce fluid accumulation in certain CSR cases.

Question 35

What is the typical prognosis for CSR?

Answer 35

CSR generally resolves on its own, with most cases improving within a few months.