CSR connections with endocrine system and cortisol

[llord]

I was diagnosed with CSR in August of 2007 in both eyes, with my right eye being worse (more fluid accumulation) than the left.  Over the past year, both eyes fluctuated in the recovery process (got better and got worse) however, the left eye eventually cleared up.  Unfortunately the right eye has not cleared up and so the retinologist I am seeing planned to administer photodynamic therapy on it if it wasn't better by my next appointment - which was on 9-15-08.  However, at my last appointment it was a little bit better (as I said, it has gotten better and worse throughout the past year) and so we decided to wait and see what happens in the next six weeks before we do the surgery.  Another reason that he decided to wait and see what happens is that - in the course of all this happening - my general practitioner referred me to an endocrinologist because bloodwork indicated that I had low blood calcium  (i also have osteoporosis) and low thyroid levels (I already take levoxyl for that but apparently the blood work still came up low on this) and he (my general practitioner) wanted to see if something was going on with my hormones/endocrine system.  When I went to the endocrinologist on 9/12/08, he ordered several more tests (which check out the thyroid level) but he also ordered a “cortisol” test that tests what my cortisol level is.  The tests that my endocrinologist ordered were: (1.) thyroid antibodies, (2) T4-free, (3.) cortisol test, (4.) 24 hour CA urine sample test.  He said that although there was no indication of “disease” within my endocrine system (thyroid disease, etc.) that it appeared that it may not be functioning efficiently.  My endocrinologist – who had told me right away at the beginning of our appointment that he had never heard of CSR and that this was out of his area - was surprised when I told him that cortisol had been linked with CSR.  When I told my retinologist about the test on 9/15/08, he said that  it might be good to also wait to have the photodynamic therapy on the right eye until we know the results of the tests; if the tests indicate that the levels of these things can be normalized with medication, that may impact on the progress of my right eye.  (My retinologist also added that – since it is unclear for the causes of CSR – even if the levels need to be normalized with medication, normalization of them still may not help my right eye get better.)  Never-the-less, he indicated that there could be a link between my CSR and problems with my endocrine system.  My question is – Has anyone ever heard of there being a link between the function of anything associated with the endocrine system (thyroid, etc.) and CSR?  If so, do you have any information about what this link is?  

[Husin]

What is the difference between AMD and CSR ?
Symptom of the both are fade of central vision, and have a light yellow circle to block the vision.
In July of 2011 My first doctor was diagnosed My right eye with AMD and gave me an injection (Avastin) to my eye, after ten days my eye got better ( yellow circle disappear) but have to ware a plus lens glasses, 4 month later the yellow circle came again, and my doctor gave me Avastin again, after 10 days disappear,  3 month later came again, and the third time Avastin can't help any more, so I see another doctor, I was surprise the second and third doctor was diagnosed my eye with CSR, and suggest me not to inject Avastin and never to take any medicine, can recover itself, unfortunately untill now 20 days more my central vision still blur.
Please advise what can I do ?
Thanks,
Husin

[John C Hagan III, MD, FACS, FAAO]

AMD = age related macular degeneration
CSR= central serous retinopathy

They don't look anything alike and are easily distinguished.

JCH MD

[JohnPereira]

What is the difference between AMD and CSR.
And can a Ophthalmologist  tell the difference just by the dilation of the eyes.

[John C Hagan III, MD, FACS, FAAO]

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[llord]

O.K.  I just wish there was something I could at least do to try to improve it.  I have some other areas in my health where I think there are problems (possible thyroid problems which I am checking into, blood pressure elavation that occurs during the middle of the day every day, a "type AAA" personality) and I can't help but think that one of these is related to this stupid eye problem.  The biggest stress about this eye problem is that it has interfered with my work.  (I hold a doctorate in elementary education and have taught at both the elementary school level and the college level.  The eye problem causes me to physically wear out during the work day to the point that I cannot keep up with my responsibilities.  I have had to stop working.  This sounds crazy because it's supposed to be just an eye problem but having to look through my eyes with the blurred and splotchy vision - for some reason - causes severe physical fatigue.  It is also emotionally very stressful to have to work so hard to see things.  I went to the retinologist recently (after being out of work completely for 6 months) and he said that my right eye had improved.  Therefore, I started substitute teaching.  However, as soon as I started back to work, my eyes seem to be worse.  (I'll have to wait until I go back to the retinologist to know for sure when they give me the OCT tests.)

[John C Hagan III, MD, FACS, FAAO]

Everyone thinks that CSR is a disease that no one deserves. So its not like smoking and getting emphysema or fat and getting diabetes.  The cause is localized inflammation in the choroid that causes leakage of fluid under the retinal layers. Why it happens we don't know.  In the past there was some belief that serveral mental stress might cause it but most researchers no longer feel that is the case.

It is a disease of younger poeple.

Other than that we're clueless.
JCH MD

[llord]

O.K., Dr. Hagan, but the thing is -- as I read about CSR and the comments related to it on this and other forums, no one knows what to link it with.  Are there theories of CSR that you know of that link CSR with anything?  If so, what is CSR linked with according to these various theories? - Linda

[John C Hagan III, MD, FACS, FAAO]

I don't think that any of the theories of CSR view any association with endocrine abnormalities as anything other than chance.

JCH MD