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 vista 821 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 685 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 651 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 658 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 822 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 810 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 747 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 613 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 699 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 672 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 520 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 582 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 541 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 586 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 521 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 499 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 473 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 435 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 467 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 432 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 418 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 463 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 463 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 447 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 455 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 480 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 454 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 447 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 589 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 439 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute vista 407 veces49-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 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvista 517 vecesNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvista 432 vecesNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvista 561 vecesNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvista 593 vecesNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votos)
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Idiopathic Central Serous Retinopathy - Bilateral - Acute - 4 months later VA 20/40 OUvista 694 vecesNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votos)
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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.
