I suffer from the above condition, what are the current and most
effective treatments for this eye disease and who are the best doctors (USA) to
consult for the best care?

Thank you

Mcjoe,

There are a number of "at home" treatments you can do to help yourself
with CSR, which is also referred to as central serous
chorioretinopathy or central serous choroidopathy.  However, almost
every site I encountered as well said that CSR would subside, in many
cases, after 3 to 6 months.

?When left alone, central serous retinopathy heals spontaneously
within 4 to 8 weeks, with full recovery of visual acuity. However,
about one-third to one-half of all patients has recurrences after the
first episode of the disease; 10 percent have three or more
recurrences. In almost half of the patients, the recurrence is within
one year of the primary episode, but relapses may occur up to ten
years later.?

?Most cases clear up without treatment in 1 or 2 months. Patients with
more severe leakage and more severe visual loss or longer persistence
of disease may be helped by laser treatment to seal the leak.?

?Central serous retinopathy ? most cases go away without any treatment
within three to four months. Full vision can return within six
months.?

Let me outline some of information I encountered for you. Most cases
of CSR will disappear after a few months. The tear in the retina will
slowly repair itself, and the fluid between the layers will dissipate.
The majorities of people afflicted with CSR are male, and have what
seems to be a stress related condition. In some people, it will come
and go. You can alter your diet, and change your health habits some
and usually get it to subside, however, in some persistent, severe
cases; they will do a couple different types of laser surgery,

The first type of laser treatments is referred to as Direct
Photocoagulation. What it does is it goes in and with heat, seals off
the tear that is letting the fluid into the eye. Findings indicate
that direct photocoagulation of the leakage point not only shortens
the acute phase of the disease but also lowers the recurrence rate to
about one fifth of what would be expected without active treatment.

Photodynamic Therapy is another kind of laser treatment that can be
done if the direct photocoagulation does not work. Current laser
therapy uses a "hot" laser to coagulate leaking blood vessels, while
destroying surrounding healthy tissue. Photodynamic therapy does not
use heat, so no damage results and the procedure can be repeated as
many times as necessary on an outpatient basis. First, a drug called
BPD-MA (also known as both Verteporfrin and Visudyne) is injected into
a vein. The drug is then picked up by lipoproteins in the blood, which
are taken up specifically by the abnormal blood vessels in the retina.
Second, a beam of red laser light is aimed into the eye. This cool
beam activates the drug, which produces a toxic form of oxygen,
causing the leaking to stop.

As far as at home remedies, to help stop the duration and occurrences
of CSR, you can try many things.

#1 Reduce stress levels. CSR is common is males with high stress jobs.
Do what you can to relax.

#2 Monitor cortisol levels. Cortisol is an adrenal-cortex hormone that
is active in carbohydrate and protein metabolism. The major adrenal
glucocorticoid, stimulates conversion of proteins to carbohydrates,
raises blood sugar levels and promotes glycogen storage in the liver. 
Some signs of high cortisol are a dark or sunken look around the eyes,
fatigue but having trouble sleeping, and lack of motivation. Ask your
doctor the best way to monitor your levels.

#3 Give up caffeine and stimulants, such as nicotine. Caffeine has a
number of effects. One is the stimulating effect on the pituitary,
which peps you up and drives up cortisol.

#4 Avoid any cortisone treatments until your condition is gone.
Generally, cortisone treatments are heavy medicine and can cause
numerous side effects including depression, immune system damage, and
loss of muscle tone and accumulation of fat, osteoporosis, and damage
to certain parts of the brain. Unless you are actually deficient in
cortisol, be wary of using these treatments. Cortisone also seems to
aggravate CSR immensely.

#5 Review your use of aspirin. Reduce if excessive. There is some
evidence that aspirin may increase the leakage of fluid from
capillaries. However, aspirin can reduce high cortisol levels that
result from pain Reference 12, and can be an alternative to steroid
medications.

The following vitamins and minerals may assist within a balanced
program of supplements: Minerals zinc, magnesium, manganese, calcium,
and vitamins B6, Pantothenic Acid (B5) and vitamin C. A person with
high cortisol levels will also be susceptible to osteoporosis and
should take care to get adequate calcium, vitamin D and Magnesium as
well as protein. Bioflavinoids may also help, as a deficiency is known
to increase the fragility of capillary and other membranes.  The
following may help to normalize immune response: Zinc, Vitamin E,
Evening Primrose Oil, and possibly Histadine, which is a histamine
precursor that can become depleted in times of stress.

#6 Increase lean protein consumption. This may improve the integrity
of the membranes that retain the sometimes-leaking fluid. Cortisol is
known to 'burn' protein so this seems like a prudent precaution in any
case.

Also, please get checked for Cushing?s syndrome. CSR is a well-known
symptom of Cushing?s disease, and you should have that ruled out. The
term Cushing's disease is used when the overproduction of cortisolis
caused by a benign tumor (adenoma) of the pituitary gland that
secretes excess amounts of ACTH, the hormone that normally stimulates
the adrenal to secrete cortisol.  Overproduction of cortisol may also
occur due to an adenoma of the adrenal gland, or to production of ACTH
by a cancer of tissue other than the pituitary.

If you would like more information on CSR or medical issues related to
it, you can contact


American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120
Phone: (415) 561-8500
Fax: (415) 561-8533
http://www.aao.org/news/eyenet/

National Eye Institute
2020 Vision Place
Bethesda, MD 20892-3655
Phone: (301) 496-5248
http://www.nei.nih.gov/

Now, as far as a doctor, I would recommend you choosing a retinal
specialist in your area. Both of the laser procedures I mentioned are
common, and other than those, the condition will probably go away on
its own, or you can treat it with non-medical actions, such as stress
reduction.

The Vitreous Society is the organization of retinal doctors; you may
search their site there for a physician near you

http://www.retinadocs.org/

In addition, this website has a newsletter they email out, talking
about treatments and doctors.

http://www.geocities.com/timjosling/csr.html


If this answer requires further explanation, please request
clarification before rating it, and I will be happy to look into this
further.

Nenna-GA
Google Answers Researcher

Searches used and WebPages referenced:

://www.google.com/search?num=100&hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&c2coff=1&q=CENTRAL+SEROUS+RETINOPATHY+treatments&btnG=Search

http://www.ivillagehealth.com/experts/eye/qas/0,,242114_175309-3,00.html

http://www.kvbc.com/global/story.asp?s=1230600

http://www.geocities.com/timjosling/csr.html

http://www.geocities.com/timjosling/csrtreat.html

http://health.allrefer.com/health/central-serous-retinopathy-treatment.html

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9686.html

://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=Photodynamic%20therapy%20%20laser&btnG=Google+Search

http://www.mdsupport.org/library/photther.html

http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=cortisol&action=Search+OMD

http://groups.google.com/groups?q=cushing%27s+disease&hl=en&lr=&ie=UTF-8&oe=UTF-8&c2coff=1&safe=off&selm=93035.082523U56149%40uicvm.uic.edu&rnum=22
(Be aware a lot of the information contained in this Google Group
refers to Cushing?s in pets. Please read with caution any other
articles)

http://www.retinadocs.org/