Ayurvedic management of Central serous chorioretinopathy (~Dhumadarshi) with pigmentary epithelial detachment: A case report

Central Serous Chorioretinopathy (CSCR) is an idiopathic condition marked by a focal serous detachment of the neurosensory retina. This typically occurs at the macula due to fluid leakage from the choriocapillaris, penetrating through compromised or hyperpermeable areas of the Retinal Pigment Epithelium (RPE). While often self-resolving, frequent recurrences or chronic manifestations can result in irreversible vision impairment. Signs and symptoms such as blurring of vision, metamorphopsia, and micropsia in CSCR resemble with Dhumadarshi (~haziness of vision), which is characterized by hazy, smoky, or distorted vision. A 36-year-old male, visited the Shalakya Tantra outpatient department with the primary complaints of blurring of vision in the left eye, along with floaters and wavy lines, for the past 20 days. Clinical assessment revealed an unaided distant visual acuity of 6/6 in the Right Eye (Oculus Dexter) and a diminished visual acuity of 6/24 in the Left Eye (Oculus Sinister). Optical Coherence Tomography (OCT) examination revealed localized serous retinal detachment at the macula with associated pigment epithelial detachment and Subretinal Fluid (SRF) accumulation, which was suggestive of left eye CSCR. The management of the case was done with Shamana (~pacification), Sthanika (~local), and Shothahara (~anti-inflammatory) treatment modalities along with Yoga therapy. At the end of the treatment, vision was improved and the accumulation of SRF was seen to be completely resolved on OCT. Thus, it can be inferred from the case report that Ayurveda interventions aid in accelerating visual restoration and reducing the accumulation of SRF. Furthermore, Ayurveda treatment strategies can be promoted and adopted as the first line of treatment for patients suffering from CSCR.