Can Testosterone Cause Retinopathy?

Hello All. I'm new to Excel male. I'm 43 yr old. Been taking TRT since January of this year. Recently added anastrozole because estrogen levels were higher than normal. Also started HCG for testicular atrophy.

First the good....This has been a great experience so far. I am a serious weight lifter and athlete. I can't tell you the comments I have received since starting TRT. I have shredded fat and gain enormous amounts of muscle mass. Libido is off the charts. Energy levels and attitude is great. I feel like I'm in the best shape of my life. I run, ride mountain bikes, lift weights, etc., I have at times almost felt guilty for the gains and condition I am in and wonder if they would be the same without TRT. I have told a few friends but not made it front page news to co-workers and other peers and business associates.

Now the bad...last week I noticed blurred vision in my left eye and getting dark grey spot directly in the center of my left eye vision. At first I couldn't decide or decipher what was happening. It came on suddenly and took me a few days to figure out exactly what the symptom was I wasn't sure if my vision was just getting worse or if something else was going on. I went to the optometrist Thursday. He took a picture of the inside of my eye and told me it looked like CSR or central serous retinopathy. He asked me if I had a stressful lifestyle and I told him yes(I own my own business that is struggling, and I am dealing with a close relative that is a drug addict and it is tearing our family up), he said this happens mostly to males age 20-45 who have stressful lives(airline pilots, stock brokers etc) Not limited to this demographic but happens mostly to men. He sent me to see a retina specialist and I went straight over. They took my medical history and right off the bat...."This condition can be linked to steroids or testosterone." Bam...holy cow, my hear sank and I crapped a brick right there. They went through all the tests dilated my eyes took tons of pictures and confirmed that it was CSR, then told me again this was linked several times to TRT and they suggested testosterone was over-prescribed and I should stop and see if my eye heals.

Basically CSR is fluid behind the retina leaking in for whatever reason in small amounts but it forms a bubble behind the retina and distorts vision. It goes away on its own in 95% of the people it happens to but can recur over and over.

I've done a little research in the last few days. It not only happens to men of high stress levels but, also those who use caffeine, lots of stimulants, exercise excessively, steroids, ......Guilty, guilty, guilty on all accounts your honor.

So since this has happened I am reaching out to this forum! Bring on the suggestions or similar situations. Has this happened to anyone on here. What did you do? Any suggestions. All input is appreciated. Thanks

 

I have been diagnosed with CSR in my left eye for 6 months and in the right eye for 1 month, I have been on trt test cyp 30mg every two days for 10 years. I have stopped taking testosterone for a month. How long after stopping will CSR go away?

 

I hope this helps:

Yes, stopping testosterone replacement therapy (TRT) can potentially reverse central serous chorioretinopathy (CSCR) in some cases. Several studies and case reports provide evidence supporting this:

Resolution of CSCR After Discontinuing TRT

1. In a case series of nine patients who developed CSCR while on exogenous testosterone therapy, two patients discontinued treatment, which led to resolution of symptoms, subretinal fluid, and improved vision to 20/20[4].

2. A case report described a patient with CSCR who experienced recurring symptoms shortly after receiving intramuscular testosterone injections. When the patient's treatment was changed from injections to a daily topical testosterone gel, the symptoms did not recur in the following months[1].

Mechanism and Timeframe

The resolution of CSCR after stopping TRT is likely due to:

- Decreased choroidal blood flow and permeability
- Reduced interaction with androgen receptors in retinal pigment epithelial cells

The timeframe for improvement can vary, but some cases show:

- Resolution of subretinal fluid within 7-8 weeks after stopping TRT[1]
- Complete resolution of symptoms and OCT findings within a few months[4]

Considerations

It's important to note that:

- Not all cases of CSCR associated with TRT may resolve completely upon discontinuation
- The natural history of CSCR includes periods of waxing and waning, so controlled studies are necessary to definitively attribute improvement to TRT cessation[3]
- The decision to discontinue TRT should be made in consultation with the prescribing physician, weighing the benefits and risks for each individual patient

While stopping TRT can lead to CSCR resolution in some cases, it's crucial to consider each patient's overall health and the reason for TRT when making treatment decisions. Close monitoring by both an ophthalmologist and the prescribing physician is recommended for patients with CSCR who are on testosterone therapy.

Citations:
[1] Central serous chorioretinopathy secondary to intramuscular testosterone therapy - PMC
[2] Advances in the treatment of central serous chorioretinopathy - PMC
[3] Risk of Central Serous Chorioretinopathy in Male Androgen Abusers - Ophthalmology and Therapy
[4] https://www.aao.org/education/editors-choice/exogenous-testosterone-therapy-linked-to-central-s
[5] Central serous chorioretinopathy in patients receiving exogenous testosterone therapy.
[6] Testosterone replacement and its association with central serous chorioretinopathy | IOVS | ARVO Journals
[7] The potential role of testosterone in central serous chorioretinopathy - PMC

 

thanks for your reply, should i also stop working out at the gym until crs goes away from my eyes? can growth hormone also cause csr?

 

I found no reports on GH and CSR, but there seem to a few on exercise:

Based on the available evidence, both resistance exercise and growth hormone may potentially worsen or contribute to the development of central serous chorioretinopathy (CSCR). Here's a breakdown of the relationship between these factors and CSCR:

## Resistance Exercise and CSCR

Vigorous physical activity, including resistance training, has been associated with an increased risk of CSCR:

- A study found that moderate to high vigorous physical activity was observed in 63.5% of CSCR patients compared to 26% of controls[7].
- The potential risk of CSCR associated with moderate/high vigorous physical activity was 5.58 times higher[7].
- Weight lifting, which involves isometric muscle contraction, was more frequently performed by CSCR patients compared to controls[2].
- Intense resistance training can lead to sharp elevations in both systolic and diastolic blood pressure, potentially affecting choroidal circulation[2].

The mechanisms behind this association may include:

- Exercise-induced hypertension, which can affect choroidal blood flow[2].
- Increased sympathetic activity during intense exercise, which has been linked to CSCR[10].
- Elevated cortisol levels following periods of intense exercise[1].

## Growth Hormone and CSCR

While there is no direct evidence linking growth hormone to CSCR, some related factors suggest a potential connection:

- Testosterone, which is often associated with growth hormone, has been implicated in CSCR:
- A study found significantly higher serum testosterone levels in CSCR patients compared to controls (357 ± 10.4 ng/ml vs. 255.94 ± 7.43 ng/ml)[4].
- Another case report described CSCR development following testosterone therapy[5].

- The relationship between growth hormone and CSCR is not well-established, but it's worth noting that:
- Growth hormone can influence testosterone levels.
- Both hormones are involved in stress responses and metabolic regulation, which have been associated with CSCR[10].

## Recommendations

Given these associations, individuals with CSCR or at risk for the condition should consider the following:

1. Moderation in exercise: Avoid excessive or intense resistance training, particularly if you have active CSCR[3].
2. Low-intensity alternatives: Opt for low-intensity exercises for 20-30 minutes, as recommended by some practitioners[3].
3. Monitor hormone levels: If undergoing hormone therapy, including testosterone or growth hormone, consult with an ophthalmologist to monitor for potential CSCR development[5].
4. Stress management: Since stress and elevated cortisol levels are associated with CSCR, incorporate stress-reduction techniques into your routine[1][10].

It's important to note that while these associations exist, individual responses may vary. Always consult with an ophthalmologist and endocrinologist for personalized advice, especially if you have a history of CSCR or are at risk for the condition.

Citations:
[1] A "Workout" for Central Serous Chorioretinopathy
[2] https://iris.unito.it/retrieve/215a...c5dd78a15b/Vigorous activity_CRSC_AJO2022.pdf
[3]

To view this content we will need your consent to set third party cookies.
For more detailed information, see our cookies page.

Accept third party cookies

[4] The relationship between the central serous chorioretinopathy, choroidal thickness, and serum hormone levels - PubMed
[5] Central serous chorioretinopathy associated with testosterone therapy - Eye
[6] Central serous chorioretinopathy: updates in the pathogenesis, diagnosis and therapeutic strategies - Eye and Vision
[7] Vigorous Physical Activity Potential Risk Factor for CSCR
[8] Vigorous Physical Activity as a Risk Factor for Central Serous Chorioretinopathy
[9] Central serous chorioretinopathy: an update on pathogenesis and treatment - Eye
[10] Central Serous Chorioretinopathy - EyeWiki

 

Thank you. One more question, long calorie deficit can affect csr. I have been keeping my calorie intake low for 6 years, my fat level is 7%. Can this also affect my csr?