Central serous chorioretinopathy (CSCR) is pathogenetically driven primarily by dysfunction of which cell type?

• A Müller cell oedema secondary to ischaemia
• B Retinal pigment epithelium (RPE) pump failure due to choroidal hyperpermeability ✓
• C Choroidal stroma inflammation similar to posterior uveitis
• D Choriocapillaris endothelial cell loss

Explanation

CSCR pathogenesis involves choroidal venous congestion and hyperpermeability (pachychoroid spectrum), leading to increased hydrostatic pressure beneath the RPE. The overloaded RPE pump (normally pumping fluid from subretinal space into the choroid) fails focally, allowing fluid to accumulate beneath the neurosensory retina. OCT angiography reveals reduced choriocapillaris flow, and enhanced-depth OCT shows dilated Haller layer vessels with focal choroidal thickening (pachychoroid). Risk factors include corticosteroid use (exogenous or endogenous Cushing's), type A personality, and mineralocorticoid excess. Eplerenone (mineralocorticoid receptor antagonist) and half-dose photodynamic therapy are evidence-based treatments.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.