Central Serous Choroidopathy

Central serous choroidopathy, more commonly called central serous chorioretinopathy (CSC), is an eye disease that affects the macula, the central part of the retina that gives sharp, detailed vision. In this disease, a clear fluid leaks from the rich blood layer under the retina (the choroid) through a tiny weak point in the retinal pigment epithelium (RPE), the “skin” under the retina. This fluid collects under the light-sensing tissue (the neurosensory retina) and lifts it up like a small blister. Because the macula is lifted, the image that reaches the brain becomes blurred, distorted, or smaller, especially in the center of vision. Many cases get better on their own, but some become long-lasting and can cause permanent damage if not treated. NCBI+1

Central serous choroidopathy (CSC), also called central serous chorioretinopathy, is an eye disease where fluid leaks from the layer of blood vessels under the retina (the choroid) and collects under the central retina (macula). This fluid makes a small “blister” and causes blurry or distorted central vision. EyeWiki+1

The exact cause is not fully known, but CSC is strongly linked with high stress, high levels of steroid hormones (from the body or from steroid medicines), sleep problems, and “Type A” personality traits. It is more common in men aged 20–50, but women can also be affected. EyeWiki+1

Other Names of Central Serous Choroidopathy

Central serous choroidopathy is known by several other names in medical books and articles. The most common name is central serous chorioretinopathy (CSC or CSCR). Doctors may also call it central serous retinopathy (CSR), central serous retinopathy of the macula, or idiopathic central serous choroidopathy, where “idiopathic” means no clear single cause is known. All these names describe the same basic problem: fluid building up under the central retina because of leakage from the choroidal blood vessels and weakness of the retinal pigment epithelium. EyeWiki+1

Types of Central Serous Choroidopathy

Doctors usually divide central serous choroidopathy into different types depending on how long it lasts, how it looks, and how much of the retina is involved. NCBI+1

1. Acute CSC
   Acute CSC is the most common type. Symptoms start suddenly, often in one eye, and the fluid under the retina usually goes away by itself within about three months. Vision often returns close to normal, though some people may still notice small changes like mild distortion or color differences.

2. Chronic CSC
   Chronic CSC lasts longer than three to six months, or comes back again and again. In this type, the fluid stays under the retina for a long time, and the RPE and photoreceptor cells may become permanently damaged. Vision can slowly get worse, and treatment (for example, with special laser or light-activated drugs) is usually needed. NCBI+1

3. Recurrent CSC
   In recurrent CSC, the first episode gets better, but new episodes happen later, sometimes in the same eye or in the other eye. Each attack brings back blurred or distorted vision. Repeated attacks can add up and cause more lasting damage to the macula over time. Dove Medical Press+1

4. Diffuse or multifocal CSC
   In some people, the leakage is not just in one small spot but in several areas or over a wide zone of the macula and nearby retina. This is sometimes called diffuse CSC, multifocal CSC, or diffuse retinal pigment epitheliopathy. It tends to be more serious, more chronic, and more likely to leave scars or atrophy in the RPE. JAMA Network+1

5. Bullous CSC
   Rarely, fluid collects in very large amounts and creates a big, dome-shaped detachment of the retina, which can even shift with gravity. This is called bullous CSC and is usually severe. It often needs quicker and more aggressive treatment. Dove Medical Press+1

Causes and Risk Factors

Central serous choroidopathy does not usually have one simple cause. Instead, many risk factors make it more likely that the disease will appear. Often more than one factor is present in the same person. PMC+2ScienceDirect+2

1. High levels of corticosteroids in the body
   The strongest known risk factor is a high level of corticosteroid hormones, either made by the body or taken as medicine. Steroids change blood flow and make choroidal blood vessels more “leaky.” This encourages fluid to pass through the RPE and collect under the retina. Steroids can be taken as tablets, injections, inhalers, nose sprays, or skin creams. ScienceDirect+1

2. Psychological stress and “type A” personality
   People who are very stressed, anxious, or have a “type A” personality—highly driven, competitive, easily tense—often have high levels of stress hormones like cortisol and adrenaline. These hormones can change the choroidal circulation and RPE function, which increases the chance of CSC. Many patients report a stressful life event before their first episode. Cureus+1

3. Use of steroid nose sprays, inhalers, or skin creams
   Even steroid medicines that are used on the skin or breathed in for asthma can slowly enter the bloodstream. Over time, this can raise the total steroid level in the body enough to increase the risk of CSC, especially when high doses or long-term use are involved. ScienceDirect+1

4. Pregnancy
   CSC is more common in pregnant women, especially in the third trimester. Hormonal changes, increased circulating blood volume, and higher levels of cortisol may all play a role. In many cases, the condition improves after delivery, but it still needs careful eye follow-up. EyeWiki+1

5. Cushing’s syndrome or other causes of high body steroid levels
   People whose bodies naturally produce too much cortisol, such as in Cushing’s syndrome, are at higher risk. Their choroidal blood vessels are continuously exposed to high steroid levels, making leakage and RPE dysfunction more likely. ScienceDirect+1

6. Obstructive sleep apnea and poor sleep
   Obstructive sleep apnea and chronic sleep problems can cause repeated drops in oxygen and changes in blood pressure during the night. These changes, along with hormonal stress responses, are linked with a higher chance of CSC and more recurrences. EyeWiki+2Wiley Online Library+2

7. High blood pressure (hypertension)
   Long-standing high blood pressure can damage blood vessels in the whole body, including the choroid. This may make the choroidal vessels thicker and more leaky, which supports the build-up of fluid under the retina and increases the risk of CSC. ScienceDirect+1

8. Helicobacter pylori infection
   Some studies have found that people with CSC are more likely to have H. pylori, a bacterium that infects the stomach. It may cause changes in the immune system or blood vessels that also affect the eye, although the exact link is still not fully understood. ScienceDirect+1

9. Kidney disease and certain glomerulonephritis types
   Certain kidney diseases, including type II membranoproliferative glomerulonephritis, have been reported more often in people with CSC. Kidney disease may change blood pressure, fluid balance, and blood vessel health, which could affect the choroid. Springer Link

10. Organ transplantation and immunosuppressive therapy
    Patients who have had organ transplants often receive high doses of steroids and other immune-suppressing drugs. These medicines, along with the stress of major illness, raise the risk of developing CSC or having repeated episodes. EyeWiki+1

11. Autoimmune diseases (such as systemic lupus erythematosus)
    Autoimmune diseases may involve chronic inflammation, steroid treatment, or both. In conditions like systemic lupus erythematosus, damage to blood vessels and the need for steroid therapy can together make CSC more likely. EyeWiki+1

12. Psychiatric disorders and related medications
    People with depression, anxiety, or other psychiatric conditions appear to have a higher risk of CSC, and some psychiatric drugs may also play a role. The link may involve chronic stress, hormonal changes, or direct effects of certain medicines on blood vessels. EyeWiki+1

13. Use of stimulants and vasoconstrictive drugs
    Medicines that tighten blood vessels, such as some decongestants or stimulants, can change blood flow in the choroid. In sensitive people, this might increase the risk of leakage and fluid build-up under the retina. ScienceDirect

14. Smoking
    Smoking damages blood vessels and affects oxygen delivery to tissues. These changes may make the choroidal circulation more unstable and increase the chance that CSC will develop or recur. ScienceDirect+1

15. Alcohol use
    Regular heavy alcohol use has been linked to CSC in some studies. Alcohol can raise blood pressure, affect liver function and hormone levels, and may change choroidal blood flow, all of which may contribute to fluid leakage under the retina. EyeWiki+1

16. Male sex and age between about 20 and 50 years
    CSC happens much more often in men than in women and usually appears in adults between 20 and 50 years old. Being male and in this age range is not a “cause,” but it is a strong background risk factor that doctors keep in mind. NCBI+1

17. Genetic background and family history
    Some people have gene variants, such as in ARMS2 or complement factor H (CFH), that may affect how their retina and choroid react to stress and inflammation. These genetic factors do not guarantee CSC, but they may increase susceptibility. Springer Link+1

18. Pachychoroid spectrum and thick choroid
    Many CSC patients have a “pachychoroid,” meaning a thicker-than-normal choroid with large, crowded vessels. This thick choroid tends to be congested and leaky. This structural background, often present in both eyes, makes CSC more likely to appear. PMC+1

19. Shift work and disturbed day–night rhythm
    Working late shifts, changing time zones often, or having irregular sleep patterns can disturb the body clock and stress hormone cycles. These changes are associated with a higher chance of CSC and with more relapses in some studies. ScienceDirect+1

20. Previous episode of CSC
    Once a person has had CSC, the retina and RPE may stay more vulnerable. These eyes are at higher risk for a new episode, especially if triggers like stress or steroid use are present again. Dove Medical Press+1

Symptoms of Central Serous Choroidopathy

CSC mainly affects the central vision of one eye, especially in the early stages. Many people notice symptoms suddenly, often over hours to days. Medscape+1

1. Blurred central vision
   The most common symptom is a patch of blurred vision in the center when looking with the affected eye. Reading, looking at faces, or seeing distant signs becomes unclear because the macula is lifted by fluid and cannot focus light properly. Cureus+1

2. Dark or gray spot in the center (central scotoma)
   Some people see a dark, gray, or dim spot right in the center of their vision. This “hole” or spot is called a central scotoma and corresponds to the area of retina that is lifted and not working normally. Orpha+1

3. Distorted vision (metamorphopsia)
   Straight lines may look bent, wavy, or crooked. Objects can appear misshapen. This distortion happens because the retina is unevenly lifted by fluid, so the image is projected irregularly onto the photoreceptors. Medscape+1

4. Objects appearing smaller (micropsia)
   Some patients feel that letters, faces, or objects look smaller than they really are. This is called micropsia and happens because the stretched retina spreads out the image over more photoreceptors, making the brain interpret it as a smaller object. Orpha+1

5. Straight lines looking bent or broken
   When looking at patterns like tiles, windows, or graph paper, straight lines can seem bent, stepped, or broken in the affected eye. This is another form of metamorphopsia and is often tested with an Amsler grid. WebEye+1

6. Colors appearing washed out or different (dyschromatopsia)
   Colors may seem dull, faded, or slightly changed compared with the normal eye. This is because the lifted macula does not receive or send normal color signals to the brain. Orpha+1

7. Reduced contrast sensitivity
   Fine differences between light and dark become harder to see. For example, reading gray print on a colored background or seeing objects in fog or dim light may be more difficult. This is a common but subtle problem in CSC. Orpha+1

8. Trouble reading small print
   Because the central retina is affected, small letters become harder to read. People may feel that they need more light or have to move the page to see clearly. This can be very disturbing for those who work with computers or documents. Cureus+1

9. Poor vision in dim light (impaired dark adaptation)
   Some patients say that their affected eye adjusts more slowly to darkness, such as when entering a dark room. The damaged or detached photoreceptors do not respond as well when light levels are low. Cureus+1

10. Slightly better vision when closing one eye
    People often notice that vision is especially strange when both eyes are open, because the healthy and affected eye send different images. Closing one eye may give clearer vision and helps them realize which eye is involved. Medscape+1

11. Change in glasses power (hyperopic shift)
    Sometimes the affected eye seems more farsighted than before, so letters appear clearer when the glasses are taken off or when the optometrist changes the lens strength. This happens because the retina has moved forward due to fluid, changing the eye’s focusing power. NCBI+1

12. Problems with depth perception
    When one eye is blurred or distorted, judging distance or depth (for example when pouring water, climbing stairs, or driving) may feel strange or uncomfortable. The brain has trouble combining the two different images into one smooth 3-D picture. Medscape+1

13. Increased glare and sensitivity to bright light
    Some people become more sensitive to bright light or glare, especially when the macula is swollen. Light may scatter differently in the lifted retina, making bright scenes uncomfortable or washed out. Cureus+1

14. Headache or eye strain
    Because the brain works harder to combine the different images from each eye, people may develop headaches or a feeling of eye strain. This symptom is not specific to CSC but often appears together with the visual changes. Cureus

15. Anxiety and worry due to sudden visual change
    Sudden change in vision can be frightening. Many patients feel anxious or worried about permanent blindness, especially when they first notice the symptoms. This emotional reaction is understandable and can itself increase stress levels, sometimes feeding into the underlying risk factors for CSC. Cureus+1

Diagnostic Tests for Central Serous Choroidopathy

Doctors use a mix of history, eye examination, and special tests to diagnose CSC and to rule out other eye diseases. The main diagnosis is clinical and imaging-based; blood and other tests look for causes and risk factors. NCBI+2Review of Ophthalmology+2

Physical Examination and Clinical Tests

1. Detailed medical and visual history
   The doctor first asks about the person’s symptoms, when they started, and how they have changed. They also ask about medicines (especially any kind of steroid), stress, sleep problems, pregnancy, high blood pressure, and other health issues. This conversation gives vital clues that the problem may be CSC and helps identify triggers that can be changed. NCBI+1

2. Visual acuity test (eye chart test)
   The person reads letters on a standard eye chart, one eye at a time. In CSC, central vision is usually reduced in the affected eye, while side vision remains better. Testing vision with and without glasses helps detect changes in sharpness and any new farsighted shift caused by macular detachment. Medscape+1

3. Pupil and eye movement examination
   The doctor checks how the pupils react to light and how the eyes move together. In CSC, these tests are usually normal, but they help rule out other serious causes of visual loss such as optic nerve disease or brain problems. A normal pupil reaction with central vision loss supports a macular origin like CSC. NCBI+1

4. Slit-lamp examination of the front of the eye
   Using a slit-lamp microscope, the doctor looks at the cornea, lens, and front chamber of the eye. In CSC, these parts are usually normal. This exam helps rule out problems like cataract, corneal disease, or inflammation that could also blur vision. NCBI+1

5. Dilated fundus examination with indirect ophthalmoscopy
   Eye drops are used to widen the pupil, and then the doctor looks at the retina and macula with special lenses and lights. In CSC, they often see a round, raised area in the macula with a shiny or blister-like appearance, sometimes with small yellow spots of pigment change. This is one of the key clinical signs of CSC. NCBI+1

6. Blood pressure and general physical exam
   Many doctors check blood pressure and examine the heart and blood vessels. High blood pressure, obesity, or signs of systemic disease may support the idea that CSC is linked to cardiovascular risk factors and stress. These findings also guide broader health management for the patient. ScienceDirect+1

Manual Functional Tests

7. Amsler grid test
   The Amsler grid is a small square with straight vertical and horizontal lines. The patient covers one eye, focuses on the central dot, and reports whether any lines look wavy, missing, or distorted. In CSC, people often see a small area of distortion or a blank spot in the center, matching the location of the macular detachment. WebEye+1

8. Near-vision reading chart
   A simple handheld reading card is used to check how well the person can read small print at close distance. In CSC, the affected eye usually reads fewer lines and may see letters as faded or twisted. Comparing both eyes helps the doctor measure the impact of the disease on near tasks like reading or phone use. Medscape+1

9. Pinhole test and refraction
   Looking through a small pinhole or going through a full “which is better, one or two?” refraction test helps separate problems caused by glasses from those caused by the retina. In CSC, vision often does not fully correct with lenses, and there may be a new slight shift toward farsightedness, which hints that the macula has moved forward due to fluid. NCBI+1

10. Confrontation visual field test
    The doctor sits facing the patient and moves fingers or a small target from the side toward the center of vision. While CSC mainly affects the central area, this simple test can show a central patch of blurred or missing vision and excludes large field losses that suggest other neuro-ophthalmic conditions. Medscape+1

Laboratory and Pathological Tests

11. Serum or urine cortisol testing
    Blood or 24-hour urine tests can measure cortisol levels. Very high levels may point to Cushing’s syndrome or other hormonal causes of steroid excess. Finding and treating these conditions can reduce the risk of repeated CSC and protect other organs as well. ScienceDirect+1

12. Pregnancy test (beta-hCG)
    In women of child-bearing age, a simple blood or urine pregnancy test is often done. Pregnancy is a known risk factor for CSC, and confirming pregnancy helps the doctor plan safe imaging and treatment and watch for natural improvement after delivery. EyeWiki+1

13. Helicobacter pylori testing
    Doctors may order a breath test, stool antigen test, or blood test to look for H. pylori infection in the stomach. If positive, treatment with antibiotics may be considered, because several studies have linked H. pylori infection with CSC, although the relationship is still being studied. ScienceDirect+1

14. Basic blood tests and kidney function tests
    Routine blood work, including kidney function, blood sugar, and complete blood count, helps detect systemic problems, such as kidney disease or metabolic disorders, that might be associated with CSC. These tests do not diagnose CSC directly but give a broader view of the patient’s health. Springer Link+1

15. Autoimmune and inflammatory marker tests
    In people with symptoms suggesting autoimmune disease, doctors may order tests such as ANA or other immune markers. Detecting conditions like lupus or vasculitis can explain why CSC appeared and may change the long-term treatment plan, including careful use of steroids. EyeWiki+1

Electrodiagnostic Tests

16. Full-field electroretinogram (ERG)
    In an ERG, special contact lenses and lights are used to measure the electrical response of the whole retina. In many CSC cases, the standard ERG is normal or only mildly changed, which helps rule out more widespread retinal diseases. However, it can show subtle dysfunction in chronic or diffuse cases. iScience+1

17. Multifocal electroretinogram (mfERG)
    The mfERG tests the function of many small areas of the central retina at once. In CSC, the response in the affected macular regions is usually reduced and delayed, even after the fluid has gone away, showing that the photoreceptors and RPE have been stressed or damaged. This test is useful in research and in complex, chronic cases. Nichigan+2PubMed+2

18. Electro-oculogram (EOG)
    The EOG measures the electrical potential of the eye during certain light and dark conditions and reflects the health of the RPE. Some studies have shown abnormal EOG signals in CSC, especially in chronic disease, suggesting that the RPE is not working properly across a wider area than just the visible leak. E-Retina+1

Imaging Tests

19. Optical coherence tomography (OCT)
    OCT is a non-contact imaging test that uses light waves to create cross-section pictures of the retina. In CSC, OCT clearly shows fluid under the neurosensory retina, small pigment epithelial detachments, and the thickness of the choroid in “enhanced depth” modes. OCT is essential for confirming the diagnosis, measuring disease activity, and following recovery or response to treatment. Springer Link+2Review of Ophthalmology+2

20. Fluorescein and indocyanine green angiography (FA and ICGA)
    In fluorescein angiography, a yellow dye is injected into a vein, and photos are taken of the retina as the dye passes through. In CSC, FA often shows one or more bright leakage spots that look like “smoke stack” or “ink blot” patterns, proving there is fluid leaking under the macula. Indocyanine green angiography uses a different dye that highlights the choroidal circulation more deeply. In CSC, ICGA shows areas of choroidal hyperpermeability and thick, congested vessels. Together, FA and ICGA help confirm CSC, distinguish it from other diseases like choroidal neovascularization, and guide treatments such as photodynamic therapy. EyeWiki+4PubMed+4Nature+4

Non-pharmacological Treatments

Below are non-drug strategies that eye doctors often suggest. Many are based on risk factors and expert opinion; some have limited direct research but are widely used in practice. AAO+1

1. Watchful waiting (observation)
In first-time, mild CSC, doctors often simply watch and wait, because many eyes recover naturally within a few months. During this time, the eye is checked with vision tests and OCT scans to see if the fluid is drying up. This avoids risks from unnecessary treatment while giving the eye a chance to heal by itself. EyeWiki+1

2. Stopping or reducing steroid medicines
CSC is closely linked with steroid pills, injections, creams, nasal sprays, and even inhalers. If possible, doctors try to stop or lower steroid doses or switch to a non-steroid option. This reduces the steroid effect on choroidal blood vessels and can help the leak close and the fluid disappear. Never stop steroids suddenly without your doctor’s guidance. Reviews in Clinical Medicine+1

3. Stress-reduction therapy
High mental stress and anxiety seem to trigger CSC in many people. Relaxation training, mindfulness, breathing exercises, yoga, or counselling can lower stress hormones like cortisol. Lower cortisol may reduce choroidal leakage and the chance of new CSC episodes over time. Reviews in Clinical Medicine+1

4. Better sleep and treating sleep apnea
Poor sleep and obstructive sleep apnea (OSA) are associated with CSC. Good sleep habits (regular sleep time, no screens late at night) and treatment of OSA (for example with CPAP) may help stabilize the circulation in the choroid and reduce fluid leakage. PMC+1

5. Reducing stimulants (caffeine, energy drinks, decongestants)
Caffeine, energy drinks, some decongestant tablets, and other stimulants can raise adrenaline and narrow or disturb blood vessels. Cutting down on these stimulants may lower stress on the choroid and reduce the chance of new fluid build-up. MDPI+1

6. Avoiding anabolic or “body-building” steroids
Anabolic steroids and some bodybuilding supplements can raise steroid hormone levels and have been linked with CSC. Stopping them, under medical supervision, removes this powerful trigger and may allow the retina to recover. Reviews in Clinical Medicine+1

7. Blood pressure control
High blood pressure can damage small blood vessels everywhere, including in the choroid under the retina. Keeping blood pressure in a healthy range with lifestyle changes (and medicines if needed) supports healthier blood flow and may protect against chronic or recurrent CSC. Reviews in Clinical Medicine+1

8. Treating Helicobacter pylori infection
Some studies suggest a link between CSC and infection with H. pylori, a stomach bacterium. When present, standard antibiotic treatment may improve general health and might reduce CSC recurrences, although evidence is still limited. PMC+1

9. Eye-friendly posture and screen habits
Long hours of focusing on screens can increase eye strain and sometimes stress. Using the 20-20-20 rule (every 20 minutes, look 20 feet away for 20 seconds), keeping screens at a comfortable distance, and working in good lighting can reduce eye fatigue and improve comfort though it does not directly cure CSC. Review of Ophthalmology

10. Protective sunglasses outdoors
Wearing sunglasses with UV protection in bright sunlight helps protect the retina and choroid from strong light exposure. This may reduce irritation of the retinal pigment epithelium (RPE) and help overall eye health. EyeWiki+1

11. Smoking cessation
Smoking harms blood vessels and increases oxidative stress in the retina and choroid. Stopping smoking improves blood flow to the eye and may lower the risk of chronic retinal damage in many eye diseases, including CSC. MDPI+1

12. Healthy body weight and regular exercise
Moderate exercise and healthy body weight improve circulation, blood pressure, and stress control. This supports the health of the choroidal vessels and retinal tissue, possibly lowering the chance of long-term CSC damage. MDPI

13. Limiting alcohol
High alcohol use can disturb sleep, raise blood pressure, and worsen mood and stress. Keeping alcohol low or avoiding it supports general and eye health and may help prevent repeated CSC episodes. MDPI+1

14. Regular eye check-ups (OCT monitoring)
Frequent follow-up with an eye specialist and OCT scans helps detect persistent or worsening fluid early. This allows timely treatment, such as photodynamic therapy or laser, before permanent central vision damage happens. EyeWiki+1

15. Using an Amsler grid at home
An Amsler grid is a simple paper with straight lines that you look at to see if the lines look bent or missing. Checking it regularly can help you notice small changes in vision early and seek care quickly. EyeWiki

16. Adjusting other hormone-related medicines
Some non-steroid drugs can affect cortisol or sex hormones and may be linked with CSC. Doctors sometimes adjust these medicines if they think they might be contributing. This helps lower hormonal stress on the choroid. ResearchGate+1

17. Psychological support or counselling
Because CSC often appears in stressed, high-pressure lifestyles, counselling or cognitive-behavioural therapy can help a person change coping strategies. Better coping can reduce stress hormones and may reduce the risk of recurrence. Reviews in Clinical Medicine+1

18. Workplace and lifestyle adjustments
Changing heavy night-shift work, constant overtime, or very high-stress roles (when possible) may lower stress load. Many patients report fewer episodes when life becomes calmer and more balanced. Reviews in Clinical Medicine+1

19. Controlling metabolic diseases (diabetes, cholesterol)
Even though CSC is not a classic diabetic eye disease, high blood sugar and high cholesterol can damage vessels and increase inflammation. Good control of these conditions supports overall eye circulation. MDPI+1

20. Patient education and shared decision-making
Understanding what CSC is, why it happens, and how treatments work helps patients make better choices and stick to follow-up plans. Education reduces fear and encourages people to notice symptoms early and protect their vision. AAO+1

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Drug Treatments

Important: No medicine is officially approved specifically for CSC by the U.S. FDA. Many of the drugs below are FDA-approved for other conditions (for example heart disease or age-related macular degeneration) and used “off-label” in CSC research. Information about these medicines comes from FDA labels on accessdata.fda.gov plus clinical studies and reviews. PubMed+4FDA Access Data+4FDA Access Data+4

Doctors always choose drugs individually based on each patient’s situation. Never start or change these medicines on your own.

I will keep each description brief to stay within your word limit.

1. Verteporfin (Visudyne®) – photosensitizer for PDT
Verteporfin is an intravenous dye used during photodynamic therapy. After injection, a special cold laser is shone onto the leaking area to activate the drug and close abnormal vessels. It is FDA-approved for age-related macular degeneration, but widely used off-label for chronic CSC, especially in half-dose PDT to reduce side effects. EyeWiki+4FDA Access Data+4FDA Access Data+4

Drug class: Photosensitizer
Usual dosing/time: Single controlled IV infusion calculated by body weight, during a PDT session (exact dose and timing are set by the retina specialist). FDA Access Data+1
Purpose & mechanism: Absorbs laser light, releases reactive oxygen species, and damages the abnormal choroidal vessels, helping the leak to seal and fluid to clear. FDA Access Data+1
Common side effects: Temporary vision changes, photosensitivity of skin and eyes for a few days, infusion-site pain; serious events are rare but possible. FDA Access Data+1

2. Ranibizumab – anti-VEGF eye injection
Ranibizumab is an anti-VEGF monoclonal antibody fragment injected into the eye. It is approved for diseases with abnormal new vessels, like neovascular AMD. In CSC, it may be used when choroidal neovascularization or other complications develop, but evidence for simple CSC is weaker than for PDT. PubMed+2MDPI+2

3. Bevacizumab – anti-VEGF (off-label injection)
Bevacizumab is a full monoclonal antibody against VEGF, approved for many cancers. Retina specialists often use it off-label for retinal diseases. In some CSC case reports, bevacizumab helped reduce fluid, especially when there was secondary neovascularization. MDPI+2ResearchGate+2

4. Aflibercept – anti-VEGF trap
Aflibercept is another anti-VEGF injection, designed to trap VEGF molecules. It is approved for AMD and other retinal vascular diseases. For CSC, it is used mainly when there are CNV complications, not as first-line therapy for typical cases. PubMed+1

5. Eplerenone (Inspra®)
Eplerenone is a selective mineralocorticoid receptor antagonist, FDA-approved for heart failure and hypertension. Several studies tested oral eplerenone in chronic CSC to reduce subretinal fluid, but recent systematic reviews show little or no clear benefit on vision compared with other treatments. EM Consulte+4FDA Access Data+4FDA Access Data+4

Drug class: Mineralocorticoid receptor antagonist
Typical dosing: Often started at a low daily dose and adjusted; exact dose, timing, and monitoring for potassium and kidney function are decided by the treating doctor. FDA Access Data+1
Purpose & mechanism: Blocks aldosterone receptors in choroidal vessels, reducing leakage and fluid build-up in animal and early human studies. FDA Access Data+2Springer Link+2
Side effects: High potassium, low blood pressure, kidney problems, dizziness, and rare allergic reactions. FDA Access Data+1

6. Spironolactone
Spironolactone is an older mineralocorticoid receptor antagonist used for heart failure, liver disease, and high blood pressure. Case series in CSC show reduced subretinal fluid and improved retinal thickness after treatment, but evidence remains limited and mixed. Medwave+2Springer Link+2

7. Finerenone (experimental in CSC)
Finerenone is a newer, non-steroidal mineralocorticoid antagonist approved for diabetic kidney disease. Some reviews mention its possible future role in CSC, based on its vascular and anti-inflammatory actions, but clinical data in CSC are very limited so far. ResearchGate+1

8. Rifampin (rifampicin)
Rifampin is an antibiotic mainly used to treat tuberculosis. Small studies and case series report that oral rifampin may help CSC by speeding up the breakdown of steroid hormones in the liver, lowering cortisol exposure. Some patients showed reduced subretinal fluid, but robust, large trials are lacking. EyeWiki+2Japer+2

9. Ketoconazole
Ketoconazole is an antifungal medicine that also lowers steroid hormone levels. Small pilot studies have suggested that it might help CSC in some patients by decreasing cortisol production, but side effects (including liver toxicity) limit its use. Review of Ophthalmology+2MedCrave Online+2

10. Mifepristone
Mifepristone is a progesterone and glucocorticoid receptor blocker. A small clinical trial is investigating short-term oral mifepristone for chronic CSC to see if it reduces fluid by blocking cortisol effects on the choroid. Results are still limited, and this use is experimental. ClinicalTrials+2Review of Ophthalmology+2

11. Acetazolamide
Acetazolamide is a carbonic anhydrase inhibitor used for glaucoma and idiopathic intracranial hypertension. It has been tested in CSC to increase fluid pump function in the RPE. Evidence does not clearly show strong benefit, and side effects can be bothersome, so it is not standard therapy. PMC+2Review of Ophthalmology+2

12. Beta-blockers (propranolol, metoprolol, labetalol – experimental)
Some beta-blockers, such as propranolol and metoprolol, have been tried in CSC to reduce sympathetic (stress-related) activity. Small studies suggest possible benefit in some patients, but data are limited and inconsistent, and these drugs are not routine treatment for CSC. Review of Ophthalmology+2Reviews in Clinical Medicine+2

13. Aspirin (low-dose, experimental)
Low-dose aspirin has been explored in CSC because it may reduce blood platelet stickiness and micro-clots in choroidal vessels. Evidence is not strong, and aspirin also increases bleeding risk, so this is not standard care and must be decided by a physician. MDPI+1

14. Melatonin (hormone supplement – borderline drug/supplement)
Melatonin is sometimes used as a “medicine” and sometimes as a supplement. A small study found that bedtime melatonin improved vision and reduced fluid in some difficult cases of CSC, possibly through antioxidant and hormone-regulating effects. Larger trials are needed. EyeWiki+1

15. Sildenafil and other PDE5/6-active drugs (very experimental)
Some reports have explored phosphodiesterase inhibitors in CSC, but these medicines are also known to trigger or worsen CSC in other people. Because of this, they are not recommended as standard treatment. Any use would only be in carefully controlled research. Survey Ophthalmology+1

16–20. Other researched systemic options (all experimental)
Other drugs discussed in reviews include indomethacin, labetalol, other anti-inflammatory agents, and various hormone-modulating drugs. Evidence for these is weak, and none are widely accepted as routine CSC therapy. They are usually considered only in special cases or research settings, and always under close specialist supervision. Reviews in Clinical Medicine+2MDPI+2

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Dietary Molecular Supplements

Supplements cannot “cure” CSC, but some may support retinal health. Evidence in CSC specifically is limited; most data come from general retinal and macular studies. Always ask your doctor before starting supplements, especially if you take other medicines. MDPI+2ResearchGate+2

1. Lutein
Lutein is a yellow carotenoid found in green leafy vegetables. It collects in the macula and works like an internal “light filter” and antioxidant. Supplementing lutein may support macular health and reduce oxidative stress, which might help the retina cope better with chronic fluid, especially in long-standing CSC. ResearchGate+1

2. Zeaxanthin
Zeaxanthin is closely related to lutein and also builds up in the macula. Together, lutein and zeaxanthin help absorb blue light and neutralize free radicals. This may protect central retinal cells from damage while the underlying CSC is treated. ResearchGate+1

3. Omega-3 fatty acids (EPA/DHA)
Omega-3s from oily fish or algae oils support retinal cell membranes and have anti-inflammatory effects. In many eye conditions, they are used to improve tear-film quality and general retinal health. In CSC, they may support the health of choroidal vessels and the RPE, although direct evidence is limited. MDPI

4. Vitamin C
Vitamin C is a water-soluble antioxidant that helps protect blood vessels and connective tissue. Adequate vitamin C intake may help the retina handle oxidative stress from fluid and light exposure, supporting healing in chronic CSC. MDPI

5. Vitamin E
Vitamin E is a fat-soluble antioxidant that protects cell membranes from damage. In combination with other vitamins and minerals, it has been studied in macular diseases and may help preserve retinal structure while other CSC treatments work. MDPI

6. Zinc
Zinc is important for many enzymes in the retina and RPE. It supports antioxidant defence systems and may help the eye repair damage. Balanced zinc intake in diet or supplements may be beneficial, but excessive zinc can cause side effects, so medical advice is important. MDPI

7. Selenium
Selenium is part of antioxidant enzymes like glutathione peroxidase. Healthy selenium levels may reduce oxidative damage in retinal and choroidal tissues and support general immune and vascular health that indirectly helps patients with CSC. MDPI

8. Curcumin
Curcumin, from turmeric, has anti-inflammatory and antioxidant effects. Experimental work suggests it may reduce inflammation and oxidative stress in many tissues, including the eye, but direct clinical evidence in CSC is still weak. It may be considered only as a supportive measure with medical guidance. MDPI

9. Resveratrol
Resveratrol is a plant polyphenol with antioxidant and vascular-protective actions. It may help stabilize small blood vessels and reduce inflammation. Again, there is no strong CSC-specific proof, but it is sometimes discussed as an adjunct to a healthy eye diet. MDPI

10. Coenzyme Q10
CoQ10 helps mitochondria (the “power plants” of cells) make energy. It may support energy supply in retinal cells stressed by chronic subretinal fluid. Like other supplements, evidence in CSC is limited, but it may be used as part of general retinal support in some cases. MDPI

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Regenerative / Stem-Cell and “Immunity Booster Drugs

Right now, there are no specific, FDA-approved stem-cell or regenerative drugs for CSC. Research in retina regeneration focuses mainly on other diseases such as age-related macular degeneration and inherited retinal dystrophies, using retinal pigment epithelium (RPE) or photoreceptor cell transplants and gene therapy. PubMed+1

For CSC, scientists are still exploring ideas like:

1. RPE cell transplantation – laboratory-grown RPE cells might one day replace severely damaged RPE in chronic cases, but this is experimental and not routine care.

2. Stem-cell–derived RPE patches – early trials in other macular diseases test implanted RPE sheets to support the retina; any CSC use would be future research only.

3. Neuroprotective agents – drugs that protect retinal neurons from damage are being studied in many eye diseases, but not yet proven for CSC.

4. Gene and pathway-targeted therapies – possible future drugs may focus on choroidal vessel leakage pathways (for example, mineralocorticoid or VEGF signalling) in more precise ways. MDPI+1

Because evidence is still at research level and not standard care, it would be misleading and unsafe to list “6 regenerative drugs with dosage” for CSC. If someone offers stem-cell injections or “immune booster drips” for CSC outside a formal clinical trial, it is important to be very cautious and talk to a trusted retina specialist.

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Surgeries and Procedures

In CSC, “surgery” mainly means procedures done in a retinal clinic, not big operations in an operating theatre.

1. Photodynamic therapy (PDT) with verteporfin
PDT is now considered one of the most effective treatments for chronic CSC. The doctor injects verteporfin into a vein, waits for it to circulate, and then shines a low-energy laser onto the leaking area in the macula. This closes abnormal choroidal vessels and helps the fluid dry, often with good vision improvement. Half-dose or half-fluence PDT is commonly used to reduce side effects. EyeWiki+4PubMed+4AAO Journal+4

2. Conventional focal laser photocoagulation
In older or selected cases, doctors may use a thermal laser to seal a leak that is away from the very center of vision. The laser makes tiny burns that close the leak but can leave small permanent scars, so it is not used near the fovea. It is less popular now than PDT because of the risk of scarring. AAO+2ScienceDirect+2

3. Subthreshold micropulse laser
Micropulse laser delivers very short “bursts” of energy instead of a continuous burn. It aims to stimulate the RPE and choroid to heal without visible scarring. Some studies show it can reduce fluid in CSC, but results are more variable than with PDT, and it is often used when PDT is not available. PubMed+2Nature+2

4. Vitrectomy with drainage (rare)
In very unusual, complicated CSC cases with other problems (like traction, epiretinal membranes, or giant RPE tears), a vitrectomy surgery (removing the gel inside the eye) with subretinal fluid drainage may be considered. This is not routine for typical CSC but can be used when multiple issues exist. ScienceDirect+1

5. Combined surgery for secondary complications
If CSC leads to complications such as macular holes or severe epiretinal membranes, surgeons may perform combined procedures (vitrectomy, membrane peeling, gas or oil tamponade). These surgeries treat the complications rather than CSC itself but may help preserve or restore central vision. EyeWiki+1

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Prevention Tips

These steps may lower the chance of getting CSC again or developing chronic disease:

1. Avoid unnecessary steroid medicines – Always ask if non-steroid options are possible and never self-use steroid creams, pills, or injections. Reviews in Clinical Medicine+1

2. Manage stress in daily life – Use healthy coping methods instead of constant pressure or overwork. Reviews in Clinical Medicine+1

3. Keep a stable sleep routine and treat sleep apnea – Good sleep supports hormonal balance and healthy vessels. PMC+1

4. Limit caffeine, energy drinks, and stimulants – This avoids extra adrenaline-type stress on vessels. MDPI+1

5. Stop smoking and avoid vaping nicotine – Protects small vessels and reduces oxidative stress in the eye. MDPI+1

6. Control blood pressure, blood sugar, and cholesterol – Follow medical advice on diet, exercise, and medicines. MDPI

7. Maintain healthy weight and regular exercise – Helps lower cortisol, blood pressure, and inflammation. MDPI+1

8. Eat an eye-friendly diet – Plenty of vegetables, fruits, and healthy fats to support retinal health (see below). MDPI+1

9. Attend regular eye check-ups – Early detection of new fluid makes treatment safer and more successful. EyeWiki+1

10. Avoid experimental unproven treatments outside clinical trials – Some internet “cures” may be expensive, useless, or harmful; always ask a retina specialist first. PubMed+1

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When to See a Doctor

You should see an eye doctor, ideally a retina specialist, as soon as possible if you notice:

• Sudden central blurry vision in one or both eyes

• Straight lines that look bent, wavy, or broken

• A dark, grey, or blurred spot in the center of your vision

• Repeated episodes of similar symptoms, especially if you already had CSC before

• Vision changes in the only seeing eye, or if both eyes are affected

If you already have CSC, urgent review is needed if vision suddenly becomes much worse, you see many new floaters or flashes, or you notice a curtain-like shadow, which could mean another emergency condition such as retinal detachment. EyeWiki+1

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What to Eat and What to Avoid

1. Eat plenty of leafy greens
Spinach, kale, and similar vegetables are rich in lutein and zeaxanthin, which support macular health and may help protect your central vision over time. ResearchGate

2. Choose colorful vegetables and fruits
Carrots, peppers, berries, oranges, and tomatoes provide antioxidants (vitamins C, E, carotenoids) that fight oxidative stress in the retina. MDPI

3. Include oily fish or plant omega-3s
Salmon, sardines, mackerel, or flaxseed and chia seeds give omega-3 fatty acids, which support blood vessels and retinal cells. MDPI

4. Add nuts and seeds
Almonds, walnuts, and sunflower seeds supply vitamin E and healthy fats that help cell membranes in the retina stay strong. MDPI

5. Drink enough water
Good hydration supports circulation and may help overall eye comfort and health, even though it does not directly cure CSC.

6. Limit very salty processed foods
Too much salt can raise blood pressure and strain blood vessels. Choose fresh foods instead of instant noodles, chips, and very salty snacks. MDPI

7. Cut down sugary drinks and junk food
Soft drinks, sweets, and fast food can worsen weight, blood sugar, and inflammation, which are bad for blood vessels, including in the eye. MDPI

8. Moderate caffeine intake
If you drink strong coffee, tea, or energy drinks, try to keep the amount moderate, especially later in the day, to avoid extra stress and sleep problems. Review of Ophthalmology+1

9. Avoid heavy alcohol use
Frequent or heavy drinking can disturb sleep and raise blood pressure. If you drink, keep it low and within medical advice. MDPI

10. Avoid unregulated “hormone boosters” or steroid-like supplements
Some gym or “performance” products secretly contain steroids or hormone-active substances that may trigger CSC. Always be careful and talk to a doctor before taking them. Japer+1

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FAQs

FAQ 1. Is CSC permanent?

In many people, CSC is temporary and clears by itself in 3–6 months. However, if fluid stays for a long time or keeps coming back, it can damage the retina and cause permanent vision loss. Chronic cases often need active treatment like PDT to protect vision. EyeWiki+1

FAQ 2. Can CSC make me blind?

Total blindness is rare, but CSC can seriously affect central vision if chronic or untreated. You may have lasting blur, distortion, or missing spots in the center of sight. Early diagnosis and proper management help lower this risk. EyeWiki+1

FAQ 3. Does CSC always need treatment?

No. Many acute, first-time cases are only observed because they often get better on their own. Treatment is more likely when fluid persists for several months, vision is badly affected, both eyes are involved, or the disease keeps coming back. AAO+1

FAQ 4. Is photodynamic therapy safe?

PDT with half-dose verteporfin is now widely used for chronic CSC, and studies show good success with acceptable safety. There are risks like temporary vision changes and photosensitivity, but serious problems are uncommon when the procedure is done by experienced retina specialists. AAO Journal+2Ajo+2

FAQ 5. Are mineralocorticoid antagonists like eplerenone a cure?

No. Recent analyses show that eplerenone and spironolactone may not clearly improve vision more than other options or observation, and the benefit on fluid is uncertain. They also carry risks such as high potassium. They may still be used in selected patients, but they are not a magic cure. Springer Link+2Medwave+2

FAQ 6. Why is stress linked to CSC?

Stress raises cortisol and adrenaline, which can change choroidal blood flow and make the choroid leaky. People with “high-pressure” lifestyles or acute stressful events are more likely to develop CSC. Stress management is therefore an important part of care. Reviews in Clinical Medicine+1

FAQ 7. Can CSC come back?

Yes. Some people have only one episode; others have several episodes over many years. Recurrence is more common if stress, steroids, or other risk factors stay the same. Preventive lifestyle changes and regular follow-up are important. EyeWiki+1

FAQ 8. Is CSC the same as macular degeneration?

No. CSC is different from age-related macular degeneration (AMD), although both affect the macula. CSC is usually related to choroidal leakage and often occurs in younger adults, while AMD is a degenerative disease mostly in older people. But chronic CSC can cause some permanent macular damage. EyeWiki+1

FAQ 9. Is it safe to use computer or phone with CSC?

Using screens does not directly damage CSC areas, but long sessions can increase eye strain and stress. Short breaks, good lighting, and healthy posture can make screen use more comfortable while your eye is being treated. Review of Ophthalmology+1

FAQ 10. Can glasses or contact lenses cure CSC?

No. Glasses can improve focus if you are short-sighted or long-sighted, but they cannot remove the subretinal fluid. CSC is a problem under the retina and needs medical observation and, in chronic cases, retinal treatment. EyeWiki+1

FAQ 11. Is CSC painful?

Most people with CSC do not feel pain. They notice blurred or distorted central vision instead. If you have eye pain with CSC, your doctor will look for another cause such as infection, inflammation, or glaucoma. EyeWiki

FAQ 12. Can I fly or travel with CSC?

Generally, flying and normal travel are safe for most CSC patients, but your retina specialist may advise avoiding travel right after eye injections or surgery. Always follow your doctor’s specific instructions. EyeWiki+1

FAQ 13. How long does PDT benefit last?

In many patients, one PDT session can give long-lasting drying of fluid and stable vision, but some may need repeat sessions if fluid returns. Long-term studies show that PDT is often more durable than many oral medicines for chronic CSC. PubMed+2Ajo+2

FAQ 14. Are dietary supplements enough instead of medical treatment?

No. Supplements and a healthy diet may support eye health, but they cannot replace medical evaluation and treatments like PDT, laser, or appropriate medicines. They are helpful “extras,” not the main treatment. MDPI+1

FAQ 15. What is the most important thing I should do now?

If you suspect CSC or already have it, the most important step is to stay under the care of an ophthalmologist or retina specialist. Share all your medicines (especially steroids), discuss stress and lifestyle, and follow the agreed plan for follow-up and treatment. Early, careful management gives the best chance to protect your central vision. EyeWiki+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: December 19, 2025.