CSR Flashcards
What is Central Serous Retinopathy (CSR) also called?
Central serous choroidal retinopathy.
What is Central Serous Retinopathy?
An exudative detachment of the sensory retina in the macula area.
What is the pathogenesis of CSR?
Poorly understood, Multiple leaks in extrafoveal RPE, FA ‘smoke stack’ or ‘ink blot’ appearance, Active choroidal leakage (ICG), Impaired choroidal circulation.
What are the key symptoms of CSR?
Sudden onset reduced VA/blurring, Hyperopic shift due to elevation of retina, Positive scotoma, Metamorphopsia, Micropsia.
What is the typical visual acuity range in CSR?
VA between 6/9 to 6/18.
What are the clinical features of acute CSR?
Detachment of sensory retina with serous fluid between RPE and photoreceptor outer segments, Oval/round shallow elevation, Absent/attenuated foveal reflex, Pigment changes, PED.
What percentage of CSR patients will experience recurrence within a year?
Around 30%.
What are the clinical features of chronic CSR?
RPE atrophy, Risk of CNV.
How can CSR be differentiated from wet AMD?
Based on age of onset and progression.
What is the general management approach for CSR in optometry?
Reassure patient, CSR resolves in 2-3 months, VA recovers in 90% of patients, Subtle metamorphopsia may persist.
When should an optometrist refer a CSR patient to an ophthalmologist?
If CSR does not resolve or for further diagnosis confirmation.
What is the ophthalmological management of CSR?
Confirmation of diagnosis, Observation, Tapering of systemic steroids.
What treatments may be considered for CSR in ophthalmology?
PDT, Focal laser, Anti-VEGF (potentially).
Does PDT or focal laser affect visual outcomes in CSR?
These treatments hasten resolution but do not affect the visual outcome.
What is the prognosis for recurrent or chronic CSR?
Guarded, especially if recurrent or chronic.
What imaging techniques are used to diagnose CSR?
Fluorescein angiography (FA), Indocyanine green angiography (ICG).
What characteristic appearance is seen on FA in CSR?
‘Smoke stack’ or ‘ink blot’ appearance.
What can chronic CSR lead to if left untreated?
RPE atrophy, Risk of CNV.
What is a potential complication of systemic steroid use in CSR patients?
Tapering may be necessary as steroids can exacerbate CSR.
What percentage of CSR patients recover their visual acuity?
Approximately 90%.
What is Central Serous Retinopathy (CSR)?
CSR is characterised by unilateral, localised detachment of the sensory retina at the macula due to fluid accumulation, with or without associated RPE detachment.
Who is typically affected by CSR?
CSR typically affects middle-aged men with a Type A personality.
What are the characteristics of a Type A personality?
Competitive, Work obsessed, Stressed, Impatient, No sense of satisfaction in achievements.
What are the common symptoms of CSR?
Unilateral blurred vision, Central vision distortion, Scotoma (thumb print/shadow in vision).
