Fig. 24.1
Central serous retinopathy fundus photograph, highlighted in red-free illumination, showing the circular lesion centred on the macula.
Fig. 24.2
Ocular coherence tomogram of the same patient, showing separation of the sensory retina from the g retinal pigment epithelium.
Advice The condition is usually selflimiting. Most patients recover normal or near-normal acuity within 3 months. Recurrences occur in approximately 20 per cent of patients, usually within a year of the initial presentation. A minority experience multiple recurrences, prolonged attacks and permanent visual impairment.
Review In most cases, patients are reviewed at 6-week intervals until disease resolution.
Laser treatment Laser treatment to the site of leakage (provided it is at least 500 |^m from the fovea) is indicated in the following situations:
- Serous detachment persisting for longer than 3 months
- Recurrence, when previous episodes have resulted in a permanent visual deficit
- When prompt restoration of vision is important (e.g. for occupational reasons).
Laser treatment has been shown to shorten disease duration and lower the recurrence rate. However, it has not been shown to affect the final visual outcome, and may adversely affect contrast sensitivity.