How Central Serous Retinopathy Is Treated

Central serous retinopathy, also called central serous chorioretinopathy, does not always require treatment. It often will go away on its own after a couple of months. Sometimes, an eye doctor may decide to treat central serous retinopathy if it is severe or recurring.

This article reviews some of the most common treatment approaches for central serous retinopathy, including monitoring, medications, and laser treatment.

Male eye doctor speaking with male patient.

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Home Remedies and Lifestyle

Most cases of central serous retinopathy do not require treatment as the fluid build-up under the retina (the light-sensitive tissue in the back of the eye) often goes away on its own after a couple of months.

If your eye doctor wants to monitor your central serous retinopathy without treating it, make sure to return for any follow-up appointments. Those appointments can help see if the fluid build-up is going away or staying the same.

Over-the-Counter Therapies

There are no over-the-counter therapies for central serous retinopathy. Eye doctors will use laser or laser-assisted treatments, medications, and monitoring. The majority of people with central serous retinopathy achieve good vision again even without any treatment.

Prescriptions

Although laser and laser-assisted treatments are more commonly used for central serous retinopathy, eye doctors sometimes will use prescription medications. Your eye doctor may be more likely to consider treatments if your central serous retinopathy does not resolve after more than two months.

Prescription medications for central serous retinopathy do not have the same amount of research as laser treatment.

Medications that have had mixed results and may be recommended include:

  • Aspirin: In one comparison of treatment for central serous retinopathy versus a control group, 109 patients using aspirin 100 mg a day once a month and then every other day for five months had quicker visual improvement and fewer recurrences compared with the 89 control patients who received no treatment.
  • Anti-vascular endothelial growth factor agents: These types of drugs, also called anti-VEGF agents for short, are used frequently for retinal diseases. Studies so far show mixed results for central serous retinopathy.
  • Adrenergic blockers: The use of metoprolol, a drug that is a beta-adrenergic blocker, was shown in one small study with six patients to improve symptoms of central serous retinopathy, but this study is dated and more research is needed.
  • Methotrexate: In a small study of 11 eyes with central serous retinopathy, methotrexate improved vision significantly after an average of 12 weeks of treatment. Most eyes did not have a recurrence of central serous retinopathy. More research is needed in this area.
  • Rifampicin: In one prospective study, researchers used 300 mg of rifampicin, an antibiotic used for tuberculosis and leprosy, twice daily for three months with 14 eyes that had central serous retinopathy. Those eyes also had six months of follow-up. The mean vision improved and thickness of the central macula—the middle part of the retina that is most affected by central serous retinopathy—also decreased in size. Still, larger studies are needed.
  • Discontinuing corticosteroid therapy: The use of high doses of corticosteroid medication is associated with central serous retinopathy. Corticosteroids are a common medication and can be found orally, in inhaled medications, eye drops, and in creams. Because of this association, stopping the use of corticosteroids could help treat central serous retinopathy. However, always check with your doctor first. Abruptly stopping steroid medication sometimes causes other negative effects on the body.

Surgeries and Specialist-Driven Procedures

The most common treatment for central serous retinopathy is called photodynamic therapy. This uses a special laser called a cold laser to treat the fluid build-up under the retina when central serous retinopathy occurs or recurs.

When photodynamic therapy is performed, an eye doctor or technicians will inject a drug called verteporfin in the arm. The drug reaches the eye, and the cold laser shined onto the eye helps to activate the drug. This treatment aims to contain the leaking fluid under the eye and improve vision. Photodynamic therapy is more commonly used if you:

  • Have had central serous retinopathy for longer than the normal amount of time.
  • Have severe leakage of the fluid under the retina.
  • Have severe vision loss.

Another therapy used for central serous retinopathy is laser photocoagulation. This is an eye surgery that eliminates any abnormal structures in the retina and can help seal the leaking fluid. It is not used often for recurrences of central serous retinopathy.

A third option for central serous retinopathy is subthreshold micropulse laser therapy, which uses a laser with repetitive, short pulses to lower build-up in the eye.

Summary

Central serous retinopathy usually goes away on its own after a couple of months. For this reason, doctors will not always treat it. When it does require treatment, photodynamic therapy is the most common treatment used. There are some prescription medications that have helped improve vision and reduced fluid build-up in studies, but they require further research.

A Word From Verywell

Keep track of your symptoms if you know you have central serous retinopathy. Let your eye doctor know of any symptom changes. If your central serous retinopathy gets better but then occurs again, let your doctor know so you can work together to find the best treatment for you.

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8 Sources
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