Caffeine is a beloved stimulant that makes people feel more alert and energetic. Everywhere you look, there is a bundle of caffeine packed into your daily coffee, pre-workout, or energy drink! With moderate caffeine consumption, your cup of coffee can be a nice pick-me-up, but with chronic, excessive consumption, caffeine can become a modifiable risk factor for your vision. Here we examine the fourth most common retinal disease: Central serous chorioretinopathy (CSCR).
CSCR is a common retinal disease typically affecting men in their 20s to 50s who exhibit an acute or sub-acute vision loss or distortion. Vision loss and distortion is caused by focal or multi-focal leaks within the retinal pigment epithelium (RPE), which presents themselves as subretinal fluid and pigment epithelial detachment. Many cases of CSCR has been considered idiopathic, however there have been studies and correlations that illustrate that caffeine use may cause or aggravate CSCR; other risk factors include steroid use and stress. Once a diagnosis of CSCR is made, the most common intervention is to induce lifestyle changes.
With a CSCR diagnosis, the retinal specialist will open up a discussion on caffeine intake, steroid exposure, and stress management. Any medication the patient is on, over-the-counter and prescription, will be discussed to review any changes. Depending on the patient’s health history and medication, other outlets of discussion can occur for any other potential lifestyle changes, such as a smoking cessation. There are also treatments available for CSCR such as photodynamic therapy (PDT), argon laser, micro pulse laser, rifampin, etc. Evidence supporting these treatments have only been done in small, uncontrolled cases. There are significant recurrence rates with treatments for CSCR as the root lifestyle habits are still likely occurring.
Central serous chorioretinopathy has several well-established risk factors. In many cases of CSCR however, these factors are inconsistent leading to idiopathic diagnoses. In multiple studies, many patients with CSCR were observed to abuse caffeine, thus it is proposed that chronic, excessive caffeine intake may be a modifiable risk factor in patients diagnosed with CSCR and may be responsible for many 'idiopathic' cases. Monitoring caffeine intake to prevent significant vision loss as well as other significant health problems is highly recommended.
Sources:
Toussaint, B. W. (2015, October 4). Caffeine and CSCR: Is there a link?. Retina Specialist. https://www.retina-specialist.com/article/caffeine-and-cscr-is-there-a-link
Central serous chorioretinopathy. EyeWiki. (n.d.). https://eyewiki.aao.org/Central_Serous_Chorioretinopathy#:~:text=Disease%20Entity-,Disease,central%20vision%20loss%20or%20distortion. Assessed and Endorsed by the MedReport Medical Review Board