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 874 views49-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 722 views49-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 697 views49-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 691 views49-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 861 views49-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 875 views49-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 778 views49-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 647 views49-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 765 views49-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 704 views49-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 574 views49-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 632 views49-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 576 views49-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 628 views49-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 572 views49-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 529 views49-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 511 views49-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 477 views49-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 504 views49-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 496 views49-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 471 views49-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 505 views49-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 518 views49-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 512 views49-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 523 views49-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 541 views49-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 498 views49-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 492 views49-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 665 views49-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 474 views49-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 440 views49-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 OU575 viewsNo 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 OU469 viewsNo 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 OU612 viewsNo 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 OU640 viewsNo 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 OU738 viewsNo 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.