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 904 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 762 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 752 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 736 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 910 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 909 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 810 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 681 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 797 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 743 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 595 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 656 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 594 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 648 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 599 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 555 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 530 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 501 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 527 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 524 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 495 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 529 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 542 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 536 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 545 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 563 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 518 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 518 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 691 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 495 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 459 x angesehen49-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 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU601 x angesehenNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU493 x angesehenNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU634 x angesehenNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU672 x angesehenNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 Bewertungen)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute - 4 months later VA 20/40 OU774 x angesehenNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 Bewertungen)
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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.
