CSCR - a common cause of visual loss in young adult

written by Dr Kenneth Fong Choong Sian on 6 December 2012

I was away last month attending the American Academy of Ophthalmology annual meeting in Chicago, USA. This is one of  the largest meeting for Eye doctors in the world, with more than 20000 people attending the meeting. It was good to update myself on the latest advances in eye surgery and catch up with old friends and colleagues. I also gave a talk at this meeting on Central Serous Chorioretinopathy (CSCR) together with other leading retinal specialists from Asia. Our course was well attended by doctors from around the world.

 
CSCR is a common cause of visual loss in young adults
CSCR is a common retinal disease where there is fluid collection at the macula. It usually affects young male adults who experience blurring of their central vision. In some severe cases, this fluid collection can be so extensive that it can look like a retinal detachment! This retinal disease is associated with steroid medications, increased stress, smoking, infection with Helicobacter pylori (a common cause of gastric ulcers), and, various other medications like Viagra. CSCR usually resolves by itself after 2 months.
 
Diagnosis of CSCR
To confirm the diagnosis of CSCR, retinal specialists usually use OCT scanning of the macula and fluorescein and ICG angiography.
 
Treatment of CSCR
Treatment is usually done if the patients vision is badly affected and there is no improvement after 1 month. I prefer to use “reduced fluence” cold laser Photodynamic Laser Therapy (PDT) to treat CSCR. “Reduced fluence” means we are using less laser power to activate the special medication that we have injected into the patients veins to get to the retina . This helps prevent loss of vision from overtreatment. As the medication to perform PDT can be quite expensive, we can also use normal “hot” laser to treat leaking areas outside of the macula. Using “hot” laser to treat the macula may result in permanent blind spots in your central vision. There are also some new studies looking at oral medications that can reduce steroid hormone levels in our body and this may also be useful for CSCR.
 
It is nice to be back home in warm Malaysia after a week in cold and windy Chicago. Chicago is a very well planned city by Lake Michigan. It has some very nice museums and public parks and would be a nice place to visit if the weather was warmer!
 
Thanks for reading and have a great week ahead!
 
Dr Kenneth Fong Choong Sian
Consultant Ophthalmologist and Retinal Surgeon 
Kuala Lumpur, Malaysia