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:-( Chronic central serous chorioretinopathy (2+ years)

My wife had fast spreading cataract in both eyes at age 42. It went from not knowing that she had cataract to operating both eyes within 3 months, then recovery did not go smoothly either. It took 6 months to a year before her eyes became OK. The stress from dealing with it all seems to have been the trigger for me getting my own set of eye issues!

Timeline of my CSCR-

A- Two plus years ago at age 44, I went for general eye examination to my eye doc. My vision was excellent but CSCR was detected in my left eye, right next to my Macula, it was one single small bump, and it was not affecting my vision in any way. Doc said not to worry, and it will be gone in a couple of months.

B- For the next 1 year it was repeated visits to my eye doc to observe the bump. Bump started becoming bigger, more vertically rather than horizontally. It never went away, and I started seeing bump in my vision, so straight objects started having a bump on it, windows, doors, web browser window etc.

C- Then I started seeing a small dark circle in my vision too, so I moved from my eye doc to a retina specialist. I had full Fluorescein Angiography done. The retina specialist confirmed CSCR and told me to be patient. She said it definitely is not AMD and I won't go blind. Optic nerve and eye in general are very healthy.

Fluorescein Angiography also showed three other old but non-active fluid leak spots, but in areas that would not have impacted my vision. The specialist believes the best option is to wait it out and give the body the chance to resolve it (based on the type of bump and the history of resolved/ older non-active leaks). She does not want to use any form of laser on it as it is right next to or touching the Macula.

I have created an image that shows the variation in my vision. The combination of metamorphopsia and the dark spot is making me very sad. Some weeks there is no dark spot/circle, other weeks it is there.

LINK TO IMAGE: https://i.ibb.co/JmnNPSj/My-Eye-1.jpg

I try not to think about it and stay relaxed and not stress myself. Is there any input someone could give me? Last month  the dark circle had gone, I was in the mountains relaxing for 2 weeks and on the last day it came back again? Sometimes I wonder if it really has anything to do with stress.

I ordered some lutein supplements, worth a try?

Best Answer
233488 tn?1310693103
MEDICAL PROFESSIONAL
Lutein is a waste of time taken for CSR. I don't know where you live but in USA, generally you would have been put on spironolactone  LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697359/  and (many other favorable results)  https://www.aao.org/editors-choice/oral-spironolactone-offers-alternative-chronic-csr      If spironoactone doesn't work then likely you would be a good candidate for photodynamic therapy.   Where do you live?  Might be time for a different retina consult. Hopefully you know steroids make CSR worse and are to be avoided.
5 Comments
Looks like you live in Switzerland.  If your retina doctor would not use spironolactone and/or does not do photodynamic treatment then I would find one within driveable distance that does. All the patients with CSR that I have referred to our retina physicians are treated with the pill if they do not resolve in a short period of time,  all have improved, some have been 'cured' (no fluid-macular edema).
Thanks for the reply, Dr Hagan. Yes, I live in Switzerland and luckily my insurance allows me to visit any specialist I want (in the country). My eye doctor referred me to this particular retina specialist with the general notion that she most likely would do photodynamic treatment. The specialist after doing various tests came to the conclusion to wait and let the body resolve the issue, she thinks the risk reward for me is not worth risking right now.

This is what the retina specialist wrote 6 months ago to my eye doctor (rough Google translation)-

"There is an active area with a small pigment epithelial detachment at the temporal inferior foveal rim. This could be responsible for the subjectively perceived metamorphopsia.
In addition, there is a currently inactive area at the top, which indicates that the patient has previously undergone RCS.
Angiographically, the currently active area is not very active, so that I do not recommend the implementation of micropulse laser therapy at the moment. Pigment epithelium elevation could disappear, therefore I would be very cautious with a therapy. If the situation changes, we can look at the micro pulse option again."

Since then, I went twice to the retina specialist:

Three months ago: When I saw for the first time the smaller dark circle  (in the linked image labelled 1 and 2). She said it is because the area is more active. She told me to come back in 3 weeks.

Three weeks later, I went back: She noticed a reduction in the active area and told me to come back in March 2022 unless something drastically changes.

This week/currently  (1+2 month since I last saw her) I am seeing larger dark/yellowish circle (in the linked image labelled 4 and 5). It seems it is the most active it has ever been although might be better than 2 days ago.


Spironolactone was never mentioned by my eye doctor nor the retina specialist. I just Googled it, and it seems that it is a diuretic. I have genetic Gout (non lifestyle related) so worried about using a diuretic. Although my organs, kidneys/liver etc function normally. I have been on Allopurinol 300mg daily since I was 30 (47 now). I am extremely fit, sporty, lean and a Vegan for the last 20+ years. My diet since my early 20s has been very good. I do my blood work every 6-12months and  everything is always normal. From B12 to all my organ functions. Yes, I don't use steroid or steroid creams etc. I have used cream for canker sores in the past that had a tiny amount of steroid but stopped them long time ago and was like once every few months anyway.

My general research for last 2 years seem to suggest that Photodynamic treatment for CSSR is hit-and-miss? Spironolactone seems to have some severe side effects.

Thanks for listening.
All treatments of CSR work by trying to get rid of fluid (edema). It is possible for the fluid to go away and leave enough disrputions that the spots (scotoma) and distortion (metamorphopsia) are permanent.  Not much more I can say. Best of luck.
Thanks. I fully understand your point.
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