Upon retinal examination, the CSC patient will characteristically show a serous retinal detachment. The most frequent symptom of CSC is a unilateral decrease of central vision. On questioning, patients with CSC frequently describe metamorphopsia or micropsia, as well as color desaturation and a prolonged dark adaptation time. Occasionally, patients will experience a migraine-like prodrome. Patients with CSC frequently have a type-A personality or have recently experienced unusual stress.
Patients receiving immunosuppressive therapy and pregnant women are at a higher risk.
Amsler grid testing may reveal a relative central scotoma with associated metamorphopsia, and recovery of acuity after bright light exposure may be delayed. The anterior segment, vitreous and optic nerve are typically normal. Retinal examination characteristically reveals serous retinal detachment. You may notice subretinal precipitates on the outer surface of the retina, as well as RPE atrophic changes. This gradually diffuses into the subretinal space.