The newest treatment options may improve outcomes and we specialize in the latest testing and treatments here at the Retina Macula Institute.Ĭytomegalovirus (CMV) retinitis is a sight-threatening disease associated with late-stage AIDS. Non-steroidal anti-inflammatory drugs (NSAIDS) have been shown, experimentally, to stimulate fluid absorption but have not been proven in a controlled clinical trial. In some complex cases, we may consider treatment with a “cold laser” (photodynamic therapy with Visudyne), intraocular injections of anti-VEGF drugs such as Avastin, or a combination of these treatments. In patients with more severe vision loss or a prolonged course of the disease, laser treatment has been shown to reduce the course of the disease and improve vision. Normally this condition clears up in a month or two. While there is no known cure, treatment is directed at the underlying modifiable risk factors such as removal of stimulants from the diet (e.g., smoking, caffeine, energy drinks, steroids) and improved life style (e.g., more sleep = less stress). In some cases, the longterm complications may be due to residual chronic activity and a more detailed evaluation of the disease process may improve the visual results. There is also a 40-50% change of recurrence over time. After central serous resolves, most patients will still have residual symptoms such as distortion, decreased color and contrast sensitivity, and vision difficulty at night. Symptoms include blurred central vision, small image size (micropsia), and distortion of the image (metamorphosia).

The “normal eye” often has subtle changes as well. Signs of central serous can include an elevation of the central retina (macula), deposits beneath the retina, dark and light color changes (hyper- and hypo-pigmentation), and, in complex cases, blood, fat deposits (lipid) and scarring (fibrosis). Risk factors for the development of this condition include a “type A personality”, the use of steroids, caffeine or other stimulants (e.g., energy drinks, dietary supplements), as well as smoking, a history of trauma, physical/emotional stress. While there is no definite known cause for this condition, we do know that it usually affects young males between the ages of 20-45. We now use high-resolution optical coherence tomography (OCT) to identify fluid under the retina and to identify subtle cases that might otherwise be missed. Indocyanine Green (ICG) angiography supports the role of the choroid in this disease and is rarely useful in management. Fluorescein angiography will show a spot of leakage which, in some cases, might have accumulated into a classic “smoke-stack” pattern and may be used to identify complications including choroidal neovascularization. Some cases are very subtle and additional testing is required. DiagnosisĬentral serous can be diagnosed by examining the retina with special lenses allowing a view of the back of the eye. This condition generally affects a person’s central vision. This leakage of fluid comes from the layers under the retina, the retinal pigment epithelium (RPE) and choroid. We specialize in these therapies here at the Retina Macula Institute.Ĭentral Serous Choroidopathy (CSC), also known as Central Serous Retinopathy (CSR), is a disease that causes fluid build-up beneath the retina. Now, new treatments are available which can preserve and even restore vision in some patients. In rare cases patients may develop other complications as a result of BRAO, such as neovascularization of the retina and iris and neovascular glaucoma. Approximately 90% of patients will recover visual acuity of 20/40 or better, though most patients will have noticeable permanent visual deficits. In general, poor vision upon presentation is indicative of a poor visual outcome. The prognosis for vision depends on whether or not the central macula was initially affected. Most patients will be evaluated from an ophthalmic standpoint every 3 to 6 months until stable. Less commonly, infectious, inflammatory or hereditary conditions can be the cause. The majority of patients are found to have carotid artery disease (narrowing), high blood pressure, cardiac disease, or combinations of these disorders. Patients will be evaluated for cardiovascular risk factors and treated accordingly, often with a family or internal medicine physician involved. Loss of visual acuity with a BRAO will mostly depend on whether there is disruption of arterial blood flow to the macula or the presence of significant macular edema (swelling).

Normal retina symptoms