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General Questions and Answers For learning, sharing your experience, and exchanging information about Multiple Sclerosis. Please discuss medications in the Medications forum, and natural supplements in Tara's forum.

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  #1  
Old 04-06-2012, 02:02 AM
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meeegun meeegun is offline
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central serous retinopathy

today i saw a retinal specialist because previously i had been told that i had suspicious depigmentation spots on my retinas that could indicate macular degeneration... well its not macular degeneration

huge sigh of relief!

what they found instead was central serous retinopathy--i have a pocket of fluid behind my retina. if you are wondering why i am telling you about this, its because (like everything else i have been diagnosed with lately i mean, 3 for 3 this year, what the heck!), no one knows why a person develops this condition BUT the risk factors are stress and...

steroids!

so, i thought you all might find this information relevant since steroids are used by most of the board members. and i think it goes without saying that we are under stress, what with living with a chronic debilitating condition and all.

CSR causes blurred and distorted vision. so if you develop these symptoms, and nothing else can explain it (like ON) you might want to get your retinas checked especially if you have recently been treated with steroids.
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Old 04-06-2012, 03:46 PM
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Alicious Alicious is offline
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Bizarrely, I was treated for years for CSR only to be told by a retinal specialist I never had it and that it was almost certainly ON, and this was confirmed by the neuro-ophth. The moral of the story: make sure your doctor actually does proper diagnostic testing, including an angiogram, to diagnose CSR.

I hope your vision is fully recovered, and sooner than later!
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Old 04-06-2012, 04:31 PM
Redwings Redwings is offline
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Hi meeegun:
Thanks for the update. I'm glad you followed up. The likelihood was [I]quite[/I] small that you had macular degeneration, so there was a good chance it was something else. (I'm sorry the ophthalmologist you saw first was a dud -- he should have known better.) In your thread about macular degeneration, you didn't mention that you had blurry or distorted vision. When did that start?

Your experience is relevant for another reason. It's yet another example of why folks who develop blurry vision should always see an eye doctor promptly. It's a good thing you did (even though you had a detour in the process). Too many people with MS call or see their neurologists about vision problems, but neurologists aren't trained or equipped to examine for and diagnose eye conditions. And no one should ever just let their neurologist make a [I]guess[/I] about what's causing the vision problem and prescribe steroids [I]over the phone[/I].

Fortunately, most cases of CSR resolve on their own within a few weeks (yay!). I hope yours clears up soon.
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Old 04-06-2012, 10:37 PM
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meeegun meeegun is offline
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redwings,

i did not mention blurry or vision changes because i did not have them. the retinal specialist agreed that this was abnormal, however, the CSR is in my left eye, which has a prescription of -525, whereas my left has a -300. this is also unusual (so i've been told) to have such a big difference in the vision in each eye. he said that i am likely right eye dominant (i agree with this statement) and because of this did not fully appreciate the visual changes that were taking place.

the only time i noticed vision changes was when i was on a decadron pulse last fall for a flare. at that time, i had blurred vision for a couple of days. for this to be related to the CSR i think would also be unusual, since from what i am reading CSR usually resolves within 3 months time, and these symptoms fall outside of this time frame. also, the visual changes were short-lived, not ongoing which i believe from what i have been reading is what i should expect.

i am perplexed by the other board member having a dx of CSR and finding out later that it was indeed ON. i may check into this further just to be sure. i did not have an angiogram but i had some imaging studies done. i meant to call and ask exactly which ones were done today but i forgot lacey brain strikes again.
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  #5  
Old 04-07-2012, 12:47 AM
Redwings Redwings is offline
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Quote:
Originally Posted by meeegun View Post
i am perplexed by the other board member having a dx of CSR and finding out later that it was indeed ON. i may check into this further just to be sure. i did not have an angiogram but i had some imaging studies done.
Back in the old days, a fluorescein angiogram was the only procedure available to confirm CSR. The state of the art at the time frequently required one. Now, OCT gives such lovely images that an angiogram may not even be necessary. The individual layers of the retina and underlying structures can be seen in such detail that sometimes even the site(s) of leakage can be identified without an angiogram. Shallow cases of CSR can be missed or misidentified on visual exam (as it sounds like yours was), but OCT will pick them up if the correct area is scanned. If OCT had been available at the time Alicious had been (mis)diagnosed with CSR, there would/could/should have been no mistake.

Below are a couple of links from ophthalmology sites showing what CSR looks like with OCT. It's quite obvious, and can't be mistaken for ON and vice versa. Although it's theoretically possible that the same eye could have concurrent ON and CSR such that the visual defects of each coincide and overlap, it would 1) be [I]extremely[/I] rare and 2) the OCT would reveal the CSR and other tests would likely reveal the ON.

[url]http://www.williamsoneyeinstitute.com/retina-center/central-serous-retinopathy[/url]

[url]http://www.drushti.com/diseases/1/central_serous_retinopathy.html[/url]
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  #6  
Old 04-07-2012, 11:43 AM
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Alicious Alicious is offline
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My CSR diagnosis was in 2007, and both the retinal specialist and the neuro-ophth told me that an angiogram should have been done at that time to confirm diagnosis (and that this is still standard procedure even in 2012). I'm willing to believe that standards for diagnosis are changing; they definitely do with medicine as better techniques become available.

I was seeing a general ophthalmologist, not a retinal specialist at the time. I would have much more faith that your retinal specialist knows how to properly diagnose CSR, although I do think asking many, many questions is warranted. I apologize if I worried you; my hope is that other people reading this thread not have the same experience that I did. A more competent doctor than mine was should be able to discuss with you just why/how the CSR diagnosis is indeed accurate. My misdiagnosis led to years of treatment for a condition I never had, and not knowing it was ON, my doctors had no reason to suspect my first (not ON) MS flare was indeed MS, so really, I'm speaking more to people who would come across this thread than to you specifically.
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Old 04-09-2012, 06:07 PM
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meeegun meeegun is offline
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Alicious,

I'm not worried, just thinking that i don't want to be misdiagnosed for a second time. if it happens to turn out to be ON this doesn't worry me as much, since its not progressive (unless i have another flare...) and for either CSR or ON, there isn't much to be done for it anyways. if it was ON i would not take the steroids because i feel terrible on them and my vision so far is unchanged. so, its not as much of a concern, but like you said, lots of questions are warranted
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  #8  
Old 04-09-2012, 07:30 PM
Redwings Redwings is offline
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Hi meegun:
You can find the answers to some of your questions by getting copies of your ophthalmology records, including your visual field and OCT printouts. There are characteristic signs and symptoms of ON, and you haven't mentioned having any of them (e.g., no visual changes). And the symptoms you have described in another thread (e.g., dizziness when reading while standing) aren't symptoms of ON (or CSR). So your records are necessary to confirm or allay your suspicions, and also to compare against any old records and future opinions.
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