CSC is the development of leakage in the RPE-choroid layer underneath the retina. This leakage comes from the native blood vessels in the choroid layer. Unlike wet macular degeneration, there are no “new” blood vessels growing. The leakage of the native vessels under the macula portion of the retina causes blurry vision.
The exact pathogenesis of CSC is not known. One hypothesis is that increased levels of steroid hormones in the body predisposes the blood vessels under the retina to leak. Those increased steroid levels may come from outside the body: for example, patients with CSC often have a history of a recent steroid injection in the back or in a joint for arthritis. The increased steroid levels may come from inside the body. The adrenal gland may make more cortisol, a steroid hormone.
Patients with CSC tend to be younger, in their 30s, 40s, or early 50s. Patients may have a history of recent steroid injection, or chronic steroid use for some other condition. Patients may be compulsive or a more stressed “Type A” personality. In my practice, I have found that a good portion of my CSC patients are heavy weight lifters, often lifting heavy weights at the gym for 1-2 hours several days a week.
What can we do for CSC? CSC, in most cases, gets better on its own after a few months. Hence, we usually recommend observation. In rare circumstances we may recommend laser to the leak sites, but in general we try to avoid laser. I also counsel patients to avoid steroids–oral, injected, and inhaled. I also recommend relaxation techniques. If patients are interested, Integris offers a “Decisions” program to help deal with stress. I also advise cutting back on heavy exercise workouts, especially heavy weightlifting.