Novel ayurveda management of central serous retinopathy (c.s.r.): an explorative case report

Nikhil Mali; Chitraveena Nibrad; Shamli Hiware; Raza Sheikh

doi:10.31893/multiscience.2025411

Keywords:

Abstract

CSR is a retinal disorder that presents with the formation of fluid at the subretinal level, indeed bringing about vision impairment. It has some relation to hormonal and fluid imbalances due to stress, especially in subjects carrying high-stress profiles. Conventional treatments involving laser therapy or anti-VEGF injections only aim at treating the symptoms rather than preventing recurrence. Maybe CSR management can also emerge from Ayurveda due to the body system balancing approach inherent within it. This case study aims to report an attempt under Ayurvedic management for effective CSR treatment with dosific balance and systemic fluid retention under the care of other stress factors. Ayurvedic treatment was given to a 45-year-old female who was having no response to one year of conventional treatment of CSR. She was given therapy in combination with Gokshuradi Guggulu and Punarnavashtaka Kwatha. Simultaneously, Brahmi Vati and Avipattikar Churna were given to decrease fluid levels, inflammation, and stress. OCT follow-up during ocular examination. During baseline assessment, significant macular edema was noticed, and reduced visual acuity at 6/18 was present in the affected eye. With the Ayurvedic intervention that lasted for three months, the OCT scan revealed reduced macular thickness, normalization of fluid balance, and normalization of vision to 6/6, in near vision improvement from N10 to N6 and no relapse for up to 1.5 years. Ayurvedic management for CSR, using Pitta balance and stress management, decreased fluid accumulation, restored vision, and reduced recurrence. This case can establish Ayurveda as a primary or adjunct therapy for chronic disorders like CSR of the retina. It points to the necessity of including holistic approaches and further studies for validation of these results.
References
1. Ali, S. S., Kaur, R., et al. (2021). Effectiveness of corporate social responsibility (CSR) in implementing social sustainability in developing countries warehousing: A hybrid approach. Journal of Cleaner Production, 324, Article 129154. https://doi.org/10.1016/j.jclepro.2021.129154
2. Barrett, B. T., et al. (2009). A critical evaluation of the evidence supporting the practice of behavioral vision therapy. Ophthalmic and Physiological Optics, 29(1), 4–25.
3. Basu, E. P., Basu, M. S., Mulla, G., et al. (2016). Restoration of visual acuity with "I.S.O.T.I.N.E." eye drops-an Ayurvedic formulation: A retrospective study of case series in various eye disorders. International Journal of Advances in Health Sciences, 3(4), 173–185.
4. Chatziralli, I., Kabanarou, S. A., Parikakis, E., et al. (2017). Risk factors for central serous chorioretinopathy: Multivariate approach in a case-control study. Current Eye Research, 42(7), 1069–1073. https://doi.org/10.1080/02713683.2017.1309472
5. Chopra, A., Doiphode, V. V., et al. (2002). Ayurvedic medicine: Core concept, therapeutic principles, and current relevance. Medical Clinics, 86(1), 75–89. https://doi.org/10.1016/S0025-7125(03)00084-3
6. Dagar, C., Pandey, A., et al. (2021). Well-being at the workplace: A perspective from traditions of yoga and Ayurveda. In The Palgrave Handbook of Workplace Well-Being (pp. 1237–1264). Cham: Springer International Publishing.
7. Dinc, U. A., Tatlipinar, S., Yenerel, M., et al. (2011). Fundus autofluorescence in acute and chronic central serous chorioretinopathy. Clinical and Experimental Optometry, 94(5), 452–457. https://doi.org/10.1111/j.1444-0938.2011.00673.x
8. Gawęcki, M., Jaszczuk-Maciejewska, A., Jurska-Jaśko, A., et al. (2019). Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy. BMC Ophthalmology, 19, Article 1. https://doi.org/10.1186/s12886-019-1265-y
9. Goebel, W., Kretzchmar-Gross, T., et al. (2002). Retinal thickness in diabetic retinopathy: An optical coherence tomography (OCT) study. Retina, 22(6), 759–767. https://doi.org/10.1097/00006982-200212000-00017
10. Kasten, E., Bunzenthal, U., Sabel, B. A., et al. (2006). Visual field recovery after vision restoration therapy (V.R.T.) is independent of eye movements: An eye tracker study. Behavioral Brain Research, 175(1), 18–26. https://doi.org/10.1016/j.bbr.2006.08.025
11. Lek, J. J., Caruso, E., Baglin, E. K., et al. (2018). Interpretation of subretinal fluid using OCT in intermediate age-related macular degeneration. Ophthalmology Retina, 2(8), 792–802. https://doi.org/10.1016/j.oret.2018.01.005
12. Mahale, P., et al. (2023). Determinants of customers' trust in Ayurvedic products–A review. International Journal of Case Studies in Business, IT, and Education, 7(4), 429–458.
13. Manasi, S., Raju, K. V., et al. (2020). Holistic health for well-being. In Coping Mechanisms for Climate Change in Peri-Urban Areas (pp. 93–121). Springer.
14. Nair, R., et al. (n.d.). Evaluation of Vrana Ropana action of Durva Ghruta and Karpoora Ghruta Lepana in Sadhyovrana-A comparative study [Master's thesis, Rajiv Gandhi University of Health Sciences].
15. Narayan, R., Bhardwaj, B., Bhardwaj, H., et al. (2024). A conceptual study of Srotas and their importance in diagnosing disease. Journal of Ayurveda and Integrated Medical Sciences, 9(5), 206–211.
16. Patil, K., et al. (n.d.). Open, controlled, randomized study of the systemic use of Shatawari Ghrita & Shatawari Ghrita Sakshi Tarpana in Pratham patalgata timer W.S.R. to simple myopia [Doctoral dissertation, Tilak Maharashtra Vidyapeeth].
17. Serebryakov, V. A., Papayan, G. V., Astakhov, Y. S., et al. (2014). An alternative approach to laser methods of treating vascular pathologies of the eye. Journal of Optical Technology, 81(11), 631–641. https://doi.org/10.1364/JOT.81.000631
18. Sharma, A., Hewege, C., Perera, C., et al. (2022). Violations of CSR practices in the Australian financial industry: How is the decision-making power of Australian women implicated? Sustainability, 15(1), Article 777.
19. Shubhashree, M. N., Naik, R., Doddamani, S., et al. (2020). Preventive strategies to combat infections–A review of traditional practices and Ayurveda concepts. International Journal of Complementary and Alternative Medicine, 13(3), 125–129. https://doi.org/10.15406/ijcam.2020.13.00529
20. Spitzyna, G. A., Wise, R. J., McDonald, S. A., et al. (2007). Optokinetic therapy improves text reading in patients with hemianopia alexia: A controlled trial. Neurology, 68(22), 1922–1930. https://doi.org/10.1212/01.wnl.0000263198.26580.64
21. Tarabishy, A. B., Ahn, E., Mandell, B. F., et al. (2011). Central serous retinopathy. Arthritis Care & Research, 63(8), 1075–1082. https://doi.org/10.1002/acr.20524
22. Ursea, R., Silverman, R. H., et al. (2010). Anterior-segment imaging for assessment of glaucoma. Expert Review of Ophthalmology, 5(1), 59–74. https://doi.org/10.1586/eop.10.2
23. Vaghasiya, N., Deva, S., et al. (2022). Concept of Jihwa Pariksha WSR to Mutravaha Sroto Vikaras. Journal of Ayurvedic and Herbal Medicine, 8(2), 125–130.
24. Widdig, W., Pleger, B., Rommel, O., et al. (2003). Repetitive visual stimulation: A neuropsychological approach to treating cortical blindness. Neurorehabilitation, 18(3), 227–237.
25. Wightman, A. J., Abbott, C. J., McGuinness, M. B., et al. (2019). Presymptomatic retinal sensitivity changes in intermediate age-related macular degeneration associated with new retinal fluid. Translational Vision Science & Technology, 8(6), Article 3. https://doi.org/10.1167/tvst.8.6.3

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Mali, N., Nibrad, C., Hiware, S., & Sheikh, R. (2025). Novel ayurveda management of central serous retinopathy (c.s.r.): an explorative case report. Multidisciplinary Science Journal, 7(8), 2025411. https://doi.org/10.31893/multiscience.2025411

[1] Ali, S. S., Kaur, R., et al. (2021). Effectiveness of corporate social responsibility (CSR) in implementing social sustainability in developing countries warehousing: A hybrid approach. Journal of Cleaner Production, 324, Article 129154. https://doi.org/10.1016/j.jclepro.2021.129154

[2] Barrett, B. T., et al. (2009). A critical evaluation of the evidence supporting the practice of behavioral vision therapy. Ophthalmic and Physiological Optics, 29(1), 4–25.

[3] Basu, E. P., Basu, M. S., Mulla, G., et al. (2016). Restoration of visual acuity with "I.S.O.T.I.N.E." eye drops-an Ayurvedic formulation: A retrospective study of case series in various eye disorders. International Journal of Advances in Health Sciences, 3(4), 173–185.

[4] Chatziralli, I., Kabanarou, S. A., Parikakis, E., et al. (2017). Risk factors for central serous chorioretinopathy: Multivariate approach in a case-control study. Current Eye Research, 42(7), 1069–1073. https://doi.org/10.1080/02713683.2017.1309472

[5] Chopra, A., Doiphode, V. V., et al. (2002). Ayurvedic medicine: Core concept, therapeutic principles, and current relevance. Medical Clinics, 86(1), 75–89. https://doi.org/10.1016/S0025-7125(03)00084-3

[6] Dagar, C., Pandey, A., et al. (2021). Well-being at the workplace: A perspective from traditions of yoga and Ayurveda. In The Palgrave Handbook of Workplace Well-Being (pp. 1237–1264). Cham: Springer International Publishing.

[7] Dinc, U. A., Tatlipinar, S., Yenerel, M., et al. (2011). Fundus autofluorescence in acute and chronic central serous chorioretinopathy. Clinical and Experimental Optometry, 94(5), 452–457. https://doi.org/10.1111/j.1444-0938.2011.00673.x

[8] Gawęcki, M., Jaszczuk-Maciejewska, A., Jurska-Jaśko, A., et al. (2019). Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy. BMC Ophthalmology, 19, Article 1. https://doi.org/10.1186/s12886-019-1265-y

[9] Goebel, W., Kretzchmar-Gross, T., et al. (2002). Retinal thickness in diabetic retinopathy: An optical coherence tomography (OCT) study. Retina, 22(6), 759–767. https://doi.org/10.1097/00006982-200212000-00017

[10] Kasten, E., Bunzenthal, U., Sabel, B. A., et al. (2006). Visual field recovery after vision restoration therapy (V.R.T.) is independent of eye movements: An eye tracker study. Behavioral Brain Research, 175(1), 18–26. https://doi.org/10.1016/j.bbr.2006.08.025

[11] Lek, J. J., Caruso, E., Baglin, E. K., et al. (2018). Interpretation of subretinal fluid using OCT in intermediate age-related macular degeneration. Ophthalmology Retina, 2(8), 792–802. https://doi.org/10.1016/j.oret.2018.01.005

[12] Mahale, P., et al. (2023). Determinants of customers' trust in Ayurvedic products–A review. International Journal of Case Studies in Business, IT, and Education, 7(4), 429–458.

[13] Manasi, S., Raju, K. V., et al. (2020). Holistic health for well-being. In Coping Mechanisms for Climate Change in Peri-Urban Areas (pp. 93–121). Springer.

[14] Nair, R., et al. (n.d.). Evaluation of Vrana Ropana action of Durva Ghruta and Karpoora Ghruta Lepana in Sadhyovrana-A comparative study [Master's thesis, Rajiv Gandhi University of Health Sciences].

[15] Narayan, R., Bhardwaj, B., Bhardwaj, H., et al. (2024). A conceptual study of Srotas and their importance in diagnosing disease. Journal of Ayurveda and Integrated Medical Sciences, 9(5), 206–211.

[16] Patil, K., et al. (n.d.). Open, controlled, randomized study of the systemic use of Shatawari Ghrita & Shatawari Ghrita Sakshi Tarpana in Pratham patalgata timer W.S.R. to simple myopia [Doctoral dissertation, Tilak Maharashtra Vidyapeeth].

[17] Serebryakov, V. A., Papayan, G. V., Astakhov, Y. S., et al. (2014). An alternative approach to laser methods of treating vascular pathologies of the eye. Journal of Optical Technology, 81(11), 631–641. https://doi.org/10.1364/JOT.81.000631

[18] Sharma, A., Hewege, C., Perera, C., et al. (2022). Violations of CSR practices in the Australian financial industry: How is the decision-making power of Australian women implicated? Sustainability, 15(1), Article 777.

[19] Shubhashree, M. N., Naik, R., Doddamani, S., et al. (2020). Preventive strategies to combat infections–A review of traditional practices and Ayurveda concepts. International Journal of Complementary and Alternative Medicine, 13(3), 125–129. https://doi.org/10.15406/ijcam.2020.13.00529

[20] Spitzyna, G. A., Wise, R. J., McDonald, S. A., et al. (2007). Optokinetic therapy improves text reading in patients with hemianopia alexia: A controlled trial. Neurology, 68(22), 1922–1930. https://doi.org/10.1212/01.wnl.0000263198.26580.64

[21] Tarabishy, A. B., Ahn, E., Mandell, B. F., et al. (2011). Central serous retinopathy. Arthritis Care & Research, 63(8), 1075–1082. https://doi.org/10.1002/acr.20524

[22] Ursea, R., Silverman, R. H., et al. (2010). Anterior-segment imaging for assessment of glaucoma. Expert Review of Ophthalmology, 5(1), 59–74. https://doi.org/10.1586/eop.10.2

[23] Vaghasiya, N., Deva, S., et al. (2022). Concept of Jihwa Pariksha WSR to Mutravaha Sroto Vikaras. Journal of Ayurvedic and Herbal Medicine, 8(2), 125–130.

[24] Widdig, W., Pleger, B., Rommel, O., et al. (2003). Repetitive visual stimulation: A neuropsychological approach to treating cortical blindness. Neurorehabilitation, 18(3), 227–237.

[25] Wightman, A. J., Abbott, C. J., McGuinness, M. B., et al. (2019). Presymptomatic retinal sensitivity changes in intermediate age-related macular degeneration associated with new retinal fluid. Translational Vision Science & Technology, 8(6), Article 3. https://doi.org/10.1167/tvst.8.6.3

Abstract

References

How to cite