central serous retinopathy

[Diggitty]

Dr. Hagan, I believe I have the after effects of central serous retinopathy.  Can this be overlooked by a few dialated eye exams over the years?  I believe I have the symptoms of once having central serous retinopathy.  When I visit the opthamologist next, and am concerned that he may have overlooked a problem, should I ask if he can check with an fluorescein angiography?  Or does a dialated exam usually rule out any central serous retinopathy.

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

Assuming you have CSR and only CSR I have found its impossible to generalize about the course it will take. You need to have a heart to heart talk with your retina Eye MD
JCH MD

[leedz]

That makes sense, thank you so much for taking the time to help me understand this.  Doesn't this "settling down" usually occur closer to the leak?  For me it was a 2007 bad leak and it was only the last few months that things got worse again since about 2009.

Someday's it seems as though there is a slight improvement and then the next day it's the same again.  Is there any chance that it could continue to settle down further or is it doubtful?

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

Distortion without leakage is very common. The fluid that leaks lifts the retina/macula up like a blister.   Then its reabsorbed but the retina/macula does not settle down evenly or flatly and there is distortion; or fibrosis or scarring occurs that throws the retina out of shapel;


Think of it like this. You have a 8 1/2  X 11 glossy photo. You take it and ball it up then unfold it and flatten it out with your hand. Eventually its more or less flat but does the picture look anything like what the photo did before your crumpled it? Of course not. It's the same principle.

JCH MD

[leedz]

Ok Thanks I appreciate that comment.  I just wondered because of the "extreme" "back-and-forth" eye movement/rapid for the duration that possibly it would cause the possibility.  It must have just been a coincidence, I'm having such a hard time understanding why the distortion started again without any signs of leakage :(

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

No use of the video games and patching "good" eye would not cause any adverse effects on the scar.
JCH MD

[leedz]

Okay, I guess the problem I am having is a year ago scans showed no leakage at all.  Than within 6 months I Had distortion again, went and got tests, again it showed no leakage.  So I have been leakage free for approximately 3 years, although all of a sudden I am left with distortion, which they claim could just be "scar-tissue" "stretching".  

My right eye is stable so I hope that doesn't happen to that eye.

Quick question, I play video games, and I patched my right eye to make the left weaker eye work so I could improve "amblyopia" (Had this since a kid but heard recent studies for adults that video games patching can help still).  So I did a 2.5 hour session and it seemed this might have made the eye/scar tissue "aggravate"?  Do you think this is possible?  If so, do you think it's possible the "scar-tissue" could settle back down again?

Thanks so much!
JD

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

in CSR fluid seeps under the retina like a blister blurring the vision. Either by treatment or by spontaneous resolution, again like a blister, the fluid goes away and the vision gets better.  In some people the fluid stays and stay and stays and in others the fluid goes away but leaves the retina surface in varying degrees of disarray causing distortion or less than perfect vision.

JCH MD

[leedz]

sorry could you ellaborate on the macula being "dried up".....

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

IF the exam done by looking in the eye and the macular OCT are normal its not likely that a FA is needed or that there is signicant residual damage.
JCH MD

[Diggitty]

I have already had an OCT for complaints of spots on an amsler grid.  I have been seeing an opthamologist for a few years now and in March had an OCT by a Retinal Specialist who said my macula looked fine.  I was just wondering if old CSR spots that have cleared up could be overlooked?

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

Although CSR usually gets better: 1. it doesn't always get better 2. if the macula 'drys up' it can often leave reduced vision and distortion due to macular damage.

You should be seeing a eye MD ophthalmologist. If you feel there is a change then a macular OCT would be helpful, less expensive and uncomfortable than a FA.

JCH MD