Central serous chorioretinopathy (CSCR) is an eye disease characterized by the accumulation of fluid between the choroid tissue layer and the retina, leading to retinal bulging and visual impairment. While this condition typically resolves within three months, it can sometimes persist chronically or recur.

Chronic CSCR treatment involves a variety of therapies including laser treatment, photodynamic therapy, and medication. Stress has been identified as a risk factor for CSCR, with elevated stress hormones like cortisol and epinephrine implicated in the buildup of sub-retinal fluid. 

Stress reduction techniques might promote healing and restore vision for CSCR. Özcan and Karapapak [International Ophthalmology] tested the effects of Mindfulness-Based Stress Reduction (MBSR) compared to a no-treatment control on visual acuity and macular thickness in patients with a recent onset of CSCR. 

The researchers randomly assigned 60 Turkish meditation-naïve adults (average age=40; 88% male) with a recent onset of CSCR to MBSR or a monitoring only control group. Recent onset of CSCR is usually not actively treated unless symptoms fail to resolve after three months. MBSR sessions consisted of daily one-hour sessions spanning three months, during which participants engaged in breath, body, and sensation-focused meditations. 

Participants’ best vision while wearing corrective lenses was assessed using a Snelling eye chart at 1, 3, and 6 months. The thickness of each participant’s retinal macula was measured by Spectral Domain Optical Coherence Tomography at each assessment point. The retinal macula thickens in CSCR due to excess fluid absorption, and a thinner macula is a sign of recovery.

Six of the initial MBSR participants were excluded from the analysis due to not completing MBSR training. Trial results showed that, at 1, 3, and 6 months, the MBSR group had significantly better visual acuity and lower macular thickness compared to controls. Controls also improved from baseline to follow-up, but their visual acuity recovery was slower, and both their visual acuity and macular thickness had less improvement compared to the MBSR group.

The findings underscore the potential of MBSR in ameliorating vision impairments and reducing macular thickness in CSCR patients. The researchers cautioned that maintaining patient engagement with MBSR was challenging.

Limitations of the study include the absence of an active control group, the lack of a stress measurement to elucidate stress as a key mechanism, and not including an intention-to-treat analysis of all individuals randomized. The description of MBSR provided was insufficient, hindering understanding of intervention components and implementation method.

Reference:

Özcan, D., & Karapapak, M. (2024). Effect of mindfulness-based stress reduction on acute central serous chorioretinopathy: A randomized control trial. International Ophthalmology, 44(1), 183. 

Link to study