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Central Serous Retinopathy : Questions


Thank you for reading my message.

I had blurry vision in my right eye for the past few months. Had my yearly eye exam on Monday and the OCT showed pigment epithelial detachment. Was referred to a Retinal Specialist who I saw today. He did a fluorescence angiography and gave me a diagnosis of Central Serous Retinopathy. I have been prescribed Spironolactone for 6 weeks (once per day for 3 days and 2 per day after that) and will see him again after that. I have summarized the Retinal Specialist's comments during my visit today as below :

1) There is a 65 % chance of recovery after the medication.

2) He recommended against wait and watch and said if there is no improvement or the fluid accumulation under the retina gets worse after 6 weeks of Spironolactone, laser treatments will have to be done.

3) The blurriness in the right eye might take time to resolve or will probably never resolve to 20/20 vision like I previously had.

4) There is a chance of recurrence in both eyes. He said excessive stress is a trigger and the condition is inherited.

1) Has anyone received treatment for CSR? What was your response?

2) I would be grateful for any comments or advice on managing CSR.

Thank you
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233488 tn?1310693103
The retina surgeon was 'dead on" in what you were told about the condition, treatment and diagnosis. I have had patients recover 20/20 vision after CSR.
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Hello Dr Hagan,

Thank you so much for your answer!  Other than taking  the prescribed Spironolactone, would you advise anything else I can do to increase my chances of  recovering with 20/20 vision and avoid a future recurrence?

Thank you
The link to stress is suspect so try and keep your pressures under control. The problem is more common in young males than females. Keep close contact with your retina surgeon
Thank you again for your helpful answers!
Blessings your way
Blessings your way
Hello Dr Hagan,

I hope you are doing well. Thank you again for your valuable replies.

I will be seeing the Retinal Specialist (RS) on Thursday after 6 weeks of Spironolactone (once per day for 3 days and 2 per day after that). My right eye blurriness has not improved in any significant manner. It has not gotten worse either. The RS told me that it takes time to regain vision even if the retinal fluid leakage has stopped. I have been exercising with weights three times per week and keeping my stress levels low.

1) Does the persistence of right eye blurriness mean that CSR is progressing?

2) If CSR is progressing,  is it advisable to opt for laser treatment right away?

3) Is  there any difference in outcomes between thermal laser treatments and photodynamic  therapy? What are the risks?

Thank you

I may mean that the pill has not had enough time to work.  Laser is never an emergency for CSR. The surgeon will have to advise based on their success and skills best of luck
Hello Dr Hagan,

Thank you so much again for your reply! I am very grateful.

Best of  luck. A very close friend of mine, a surgeon has CSR so I have followed developments closely. My friend has done well. He took, may still be taking, spironolactone and did not have to have laser.
That's great to hear! Thank you.
Hello Dr Hagan,

Just an update :  Had my visit yesterday. OCT showed a 30% decrease in the  fluid. The Retina Specialist will see me again in six weeks. He said I might have to be take Spironolactone for up to six months and may be able to avoid laser therapy if the response continues to be good, which was exactly your answer. If you have any other comments, I am eager to hear. Thank you!
Fabulous news. Chances are good over time the rest of the fluid will reabsorb.
Thank you, Dr.Hagan!  Your answers provided a lot of clarity for me.  Thank you for your time.
You  are welcome
Hello Dr. Hagan,

I hope you are doing well. If you don't mind, I have a question:

Since the last week of June, I started training with 20 lbs dumbbells' at home three times per week. I feel good, but my sex drive is considerably lower compared to before I started on Spironolactone. I certainly want to get better when it comes to CSR and will continue taking Spironolactone and  also work with dumbbells. '

1) Is this a common side effect?
2) Will the sex drive return after I stop  Spironolactone at a future time?
2) Any advice from you on increasing my sex drive when taking Spironolactone?

I have asked the same question to  my Retina Specialist as well. Just thought of asking you as well.

Thank you
I never mind saying "I don't know" and that is what I'm saying. I don't use that medication. In our patients with CSR, I refer then to the two retina MDs in our practice. You would have to ask your prescribing physician.
Avatar universal
Got it. Thank you again, Dr Hagan!
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