Central Serous Retinopathy (CSR) – Ayurvedic Herbal Treatment

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Central serous retinopathy (CSR), also known as central serous chorioretinopathy (CSC), is a disease of the eye and retina, which affects vision. CSR is known to be closely related to stress, gastritis (H. pylori bacteria), kidney disease, and the use of medications like steroids. This condition usually affects males from the age of 20 to 50 years; however, females too may be affected. This condition results from leakage of choroidal fluid due to breaks in the retinal pigment epithelium, resulting in a swelling beneath the retina which accumulates under the central macula. This causes blurred or distorted vision, known as metamorphopsia. Retinal detachment may cause a blurred or grey spot in the central visual fluid.

Modern treatment of CSR consists of removing the known cause of the condition, discontinuing steroids, and providing counselling and psychotherapy for stress. No medication is known to provide benefit in the treatment of this condition; however, some physicians are of the opinion that mild dose aspirin may help in early recovery. Some patients report benefit with a short course of steroids; however, this treatment is controversial and possibly may cause a relapse or aggravation of the condition in the long run. Hot laser treatment, or cold laser is known to provide benefit by plugging the leakage in the retinal epithelium; however, care needs to be taken in the implementation of this treatment in order to prevent damage to the retina and long-term scarring.

The overall prognosis of this condition is usually quite good, with more than 90% patients reporting improvement within the first six months. However, about 5% of patients may have rapidly deteriorating vision due to a condition known as Type II CSR, in which there is a shallow but persistent fluid build-up. A few patients may report recurrence of the condition, resulting in progressive loss of vision. Scarring may cause persistent problems such as decreased night vision, reduced color discrimination and distorted vision.

Ayurvedic herbal treatment is especially useful in patients with recurrent CSR and in those patients with little or no response to modern medications or laser therapy. The aim of treatment is to prevent leakage of fluid by strengthening the basement retinal pigment epithelium and helping to resolve the fluid accumulation, so that retinal detachment can be treated or prevented. Treatment is also aimed at reducing stress and preventing strain of the internal parts of the eye.

Medicines like Saptamrut Loh, Tapyadi Loh, Ekangveer Ras, Trayodashang Guggulu, Maha Triphala Ghrut, Maha Manjishthadi Qadha, Saarivadi Vati,: Punanava Mandur, Lakshadi Guggulu, and Rasayan Ghan Vati are especially useful in the management of this condition. Herbal medicines which are useful in the treatment of CSR include Manjishtha (Rubia cordifolia), Saariva (Hemidesmus indicus), Triphala (Three fruits), Punarnava (Boerhaavia diffusa), Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Yashtimadhuk (Glycyrrhiza glabra), Patol (Tricosanthe dioica), Patha ( Cissampelos pareira), Musta (Cyperus rotundus) and Kutki (Picrorrhiza Kurroa).

Medicines like Praval Panchamrut, Sutshekhar Ras and Kamdudha Ras are used to treat associated gastritis. Gokshuradi Guggulu, Chandraprabha Vati, and Punarnavadi Qadha are used to treat associated chronic kidney inflammation. Medicines like Saraswatharishta, Prasham, Brahmi (Bacopa monnieri), Jatamansi (Nardostachys jatamansi) and Shankhpushpi (Convolvulus pluricaulis) are used to treat associated stress along with counseling.

Oral medications like Triphala Ghrut, Yashtimadhuk Ghrut, Shatavari Ghrut, and eye drops containing Triphala, Yashtimadhuk, and rose water can be used on a long-term basis to prevent relapse of the condition. Most individuals affected with chronic or recurrent CSR require Ayurvedic herbal treatment for about three to six months. Regular treatment can provide complete relief to individuals affected with this condition, as well as prevent a relapse and long-term complications. This treatment can also be given concurrently with modern therapy like laser treatment. Ayurvedic herbal treatment thus has a definite role to play in the management and treatment of CSR.