Acute Bilateral Central Serous Retinopathy - Bullous Serous Retinal Detachment
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49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 703 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 579 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 559 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 563 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 731 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 725 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 647 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 521 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 603 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 543 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 435 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 498 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 431 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 478 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 437 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 428 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 402 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 371 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 387 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 370 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 351 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 377 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 378 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 386 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 377 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 417 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 369 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 345 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 469 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(1 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 356 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 349 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 434 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 342 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 478 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 519 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute - 4 months later VA 20/40 OUvu 601 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
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49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
