Hi anil, you should visit Dept. of Medical ophthalmology, Retina Uvea (AIIMS)
As far as central serus retinopathy is concerned, Differential
diagnosis should be immediately performed to rule out retinal
detachment, which is a medical emergency. Additionally, a clinical
record should be taken to keep a timeline of the detachment.
Most eyes with CSR undergo spontaneous resorption of subretinal fluid
within 3–4 months, recovery of visual acuity usually follows. Any
ongoing corticosteroid treatment should be tapered and stopped, where
possible. It is important to check current medication, including nasal
sprays and creams, for ingredients of corticosteroids, if found seek
advice from a medical practitioner for an alternative.
Patients sometimes present with an obvious history of psychosocial
stress, in which case counselling and expectancy is relevant.
Treatment should be considered if it does not disappear within 3–4
months, spontaneously or as the result of counselling.
Laser photocoagulation, which effectively burns the leak area shut,
may be considered in cases where there is little improvement in a 3 to
4 month duration, and the leakage is confined to a single or a few
sources of leakage at a safe distance from the fovea. However, for
many cases the leak is very near the central macula, where
photocoagulation would leave a blind spot or the leakage is widespread
and its source is difficult to identify. Foveal attenuation has been
associated with more than 4 months' duration of symptoms, however a
better long-term outcome has not been demonstrated with laser
photocoagulation than without photocoagulation. Laser photocoagulation
can permanently damage vision where applied. Carefully tuned lasers
can limit this damage. Even so laser photocoagulation is not a
preferred treatment for leaks in the central vision and is considered
an outdated treatment by some doctors.
In chronic case Transpupillary thermotherapy has been suggested as an
alternative to laser photocoagulation where the leak is in the central
macula.
Photodynamic therapy (PDT) with verteporfin has shown promise as an
effective treatment with minimal complications. Follow up studies have
confirmed the treatment's long-term effectiveness including its
effectiveness for the chronic variant of the disease. Indocyanine
green angiography can be used to predict how the patient will respond
to PDT.
Yellow micropulse laser has shown promise in very limited trials.
Other experimental treatments include anti-VEGFs and several oral medications.
Warm regards,
Yogesh Chhabra
On 9/19/14, Anil Kumar anil4aifrie...@gmail.com wrote:
Dear List,
One of my colleagues is suffering from Resolved Central Serous
Retinapthy. It is there in both the eyes. Blocked Flurosence in
macular area of right eye and fluid accumalation is observe in both
the eyes. Focal laser treatment was done in both the eyes. Evastin
and Lucentus injections were given in the right eye. Present status
is , vision is almost nil in the right eye and very dull in left eye .
The question is whether CSR is curable? if, either in Ayurveda or in
Allopathy treatment is advisable?
Your quick response in this regard would be highly appreciated.
Thanks in anticipation,
(Anilkumar K.R.)
Email: anilhi...@gmail.com / anilkuma...@ntpc.co.in
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