Ophthalmologists like to refer to retinopathy of the centralis serosa as a “managerial disease”. The reason for this is that a lot of stress can trigger this visual disorder. A gray spot appears in the field of vision, objects are seen distorted and reading and recognizing the colors is difficult.
What is central serous retinopathy?
Central serous retinopathy is a disease of the retina. Here, fluid leaks from the choroid, causing the retina to be lifted off from the pigment epithelial layer in a localized manner. This is called retinal detachment due to swelling. It is pushed forward and closer towards the lens. For what does cll stand for, please visit biotionary.com.
The unevenness that occurs as a result lifts the photoreceptors out of their conventional position. In rare cases, if the pigment layer is intact, the retina and the retinal pigment epithelium are detached together. The disease primarily affects men between the ages of 20 and 50, but it can also affect women. Occurrence is often related to physical or mental stress.
Causes
The exact cause of retinopathy centralis serosa, the change in the retina, is not known. However, stress has been mentioned very frequently as a trigger for the disease for many years. Studies have shown that those affected often show strong competitive behavior, have a lot to organize and manage and are agile.
This is also where the name “manager disease” comes from. However, this does not mean that every stressed person will develop the eye condition. The reason for this is a different processing of stress. The disease can also be associated with an increased concentration of the stress hormone cortisol.
Experts suspect that a genetic susceptibility can also promote the occurrence of central serous retinopathy. The same applies to an infection with Helicobacter pylori, a stomach germ. In this connection, too, the eye disease was observed in part. Ultimately, the clinical picture of retinopathy centralis serosa has not yet been adequately researched.
Symptoms, Ailments & Signs
A gray-black hole appears in the field of vision in central serous retinopathy. The view is clouded by a gray haze, objects appear distorted or double. All of this is part of the typical symptoms of the eye disease, which often occurs quite suddenly.
In addition, there is often unilateral or bilateral farsightedness due to the detachment of the retina from the choroid. Another sign of central serous retinopathy is seeing waves. Equally typical is the loss in the central visual field. As a result, one spot in the center of the field of vision is seen grey, black or out of focus.
Diagnosis & course of disease
If there is a suspicion that the retinopathy is centralis serosa, an anamnesis and a careful examination by the ophthalmologist are necessary. The reason for this is that the changes in vision can also result from other diseases that are associated with similar symptoms. Various options are available to the doctor for precise diagnosis, for example an eye test.
This is usually a hyperopic condition of the affected eye. Device-based perimetry is also possible, for example threshold perimetry, which is used to determine and quantify the scotoma. Fundoscopy shows ophthalmoscopically visible edematous swelling of the retina.
The color sense test and spectral optical coherence tomography|spectral optical coherence tomography (SOCT) are also used. Here, the detachment of the retina can be made directly visible, because a cross-sectional image is produced with this recording technique. There are acute and chronic forms of central serous retinopathy, which can occur on one or both sides.
In the acute form, the disease usually resolves spontaneously within three to six months of onset. Therefore, it is common to only start therapy after three months. A significant loss of vision remains only in isolated cases, but one or more outbreaks of the disease can occur. If the central serous retinopathy occurs repeatedly and leaves changes behind, it is referred to as a chronic form. In this case, treatment should be started earlier.
Complications
Central serous retinopathy is rarely associated with complications. Spontaneous healing usually takes place. However, the disease itself occurs as a complication of a stress reaction in heavily stressed people. Since it often afflicts leaders, it is also commonly referred to as a manager’s disease. Although the retina partially detaches due to the penetrating fluid from the choroid, blindness almost never occurs.
After several weeks or months, the disease will heal without treatment and vision will return to normal. Sometimes, however, more severe courses take place. Then therapy should be considered. In photothermal therapy, the retina is treated with heat. However, if the swelling is outside the macula, laser treatment should be carried out in severe cases, since the photothermal therapy leads to the destruction of the retina in this case due to the heat generated.
After the symptoms have subsided, some patients have recurrences. To avoid such relapses, smoking and taking medication containing cortisone should be avoided. Reducing stress also promotes complete healing.
Ambitious and impatient young men are mostly affected, but they are so unsettled by the sudden visual disturbances that they may also need psychological support. Within the framework of psychotherapy, it can be discussed how stress reduction can be achieved in a specific case.
When should you go to the doctor?
Central serous retinopathy should always be treated by a doctor. This disease does not heal itself. If left untreated, the disease can lead to severe limitations and problems in everyday life. A doctor should be consulted if the patient suffers from a disturbed field of vision. This can lead to the appearance of a black or gray dot in the field of vision, so that the affected person can no longer recognize objects correctly.
Sudden farsightedness also indicates central serous retinopathy and must be examined if it occurs relatively suddenly and without any particular reason. Likewise, the visual field can be accompanied by failures, so that the person concerned also suffers from sensory disturbances. Many patients are also no longer able to recognize colors correctly due to central serous retinopathy. If these symptoms occur, an ophthalmologist can be consulted. As a rule, central serous retinopathy can be treated effectively if it is discovered early.
Treatment & Therapy
In most cases, no treatment is required for central serous retinopathy because the disease usually resolves on its own. Those affected often recover from the visual disturbances within the next few months. This only requires patience. In the event of a severe course or repeated relapses, treatment should be initiated.
In these cases, laser treatment can be considered, which is very common in this eye condition. The leaking area in the choroid is sclerosed with the laser. The prerequisite for this, however, is that there is an eccentric position with regard to the source point.
If everything goes well, the laser light will cause the retina to stick to its substrate again. This can lead to slight scarring, but this is not a problem. In some patients, however, repeated lifting of the retina causes scarring changes over a large area, so that vision is noticeably impaired. Even with spontaneous healing, there are sometimes slight limitations in vision or quality of vision.
Another method to treat central serous retinopathy is photodynamic therapy. Here, a light-sensitive drug is injected into the arm vein, which is distributed throughout the body within the next 15 minutes, which also applies to the vessels of the choroid. The drug is specifically activated by laser radiation and the leaking blood vessel is closed.
Prevention
In order to avoid the occurrence of retinopathy centralis serosa, the stress load should be reduced. Relaxation methods such as Qi Gong and autogenic training are also helpful. This contributes to balance and an optimal work-life balance. It is always important to be aware of how stress affects the body. Sport is also helpful, because exercise strengthens the immune system and promotes the reduction of stress hormones, which are suspected of triggering central serous retinopathy.
Aftercare
Unlike similar eye diseases, retinopathy does not lead to complete blindness. Even without ophthalmological therapy, retinopathy can heal on its own. If the symptoms persist, targeted treatment should be considered. Symptoms can last a few weeks or months.
A visit to the ophthalmologist is nevertheless advisable, in the course of aftercare the condition after the therapy should be maintained. The medium to long-term goal is to avoid a relapse, and the patient should live a symptom-free life for the long term. Treatment options are surgical or medicinal. During aftercare, the healing progress is checked.
If an operation has been performed on the eyes, the well-known post-operative check-up takes effect. It ends with discharge from the clinic. If the desired effect can be achieved with the appropriate medicine, the specialist discontinues the therapy and schedules follow-up care. The condition of the eyes is also checked at regular intervals after an operation.
If the symptoms return, the treatment starts again. The patient can also contribute to the follow-up care by eating healthily and attending check-up appointments. However, excessive alcohol and nicotine consumption should be avoided. The complete renunciation of these stimulants would be ideal.
You can do that yourself
Central serous retinopathy often occurs in connection with a stressful day at work. It is therefore helpful if those affected lower their stress level. Physical relaxation and also mental exercises like meditation can help to reduce vision problems. In any case, it is important to consult an ophthalmologist as soon as possible if problems arise.
After the examination and the therapy recommendations, those affected can do something themselves to make everyday life easier. Rest breaks not only protect the eyes, but the entire organism. Proper relaxation usually resolves the symptoms without medication. The doctor may also suggest a special therapeutic approach. This depends on the severity of the disease and the individual situation of the patient. In addition to a healthy lifestyle with nutritious food and enough exercise, it helps to reduce stress and avoid stimulants such as nicotine and alcohol.
Drugs containing cortisone are also considered to be triggers for the eye disease. In consultation with the doctor, it should be considered whether it makes sense to stop taking certain medications for chronic diseases. This could support self-healing, but the other possible complaints should also be taken into account.
