Acute Central Serous Retinopathy - Broad Leak
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45-year-old man was seen in the office on 11/2/2010. He has noticed decreased vision in the right eye starting about two days ago. It was like a shadow in his vision. He is in excellent health. He takes no systemic medications, definitely no steroids, and he has no headaches, tinnitus or problems lately. He does have a little bit of pressure around his sinuses.
VISUAL ACUITY: Vision OD is 20/60, OS is 20/20. IOP: OD 15. There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. There is a serous macular detachment.
OS: Vertical C/D ratio is 0.5. The macula and periphery look normal.
OCT SCAN: The OCT scan of the right eye shows a serous macular detachment.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows a pigment epithelial detachment just inferior to the fovea with leakage later into the serous macular detachment. There is also a small pigment epithelial detachment inferonasal to the serous detachment. The left eye is angiographically normal..
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY WITH SEROUS MACULAR DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient the right eye does have central serous retinopathy and 95% of the time the vision improves and the subretinal fluid absorbs without treatment. Generally though, people do notice things a little smaller in the eye after the subretinal fluid does absorb. There is about a 25% recurrence rate and if the fluid does not absorb over the next three to six months, then it is reasonable to consider therapy. At this moment, probably photodynamic therapy is the most reasonable alternative.
I asked him to return for check in four months, sooner should he notice a problem.
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eyevista 519 veces45-year-old man decreased vision in the right eye starting about two days ago. VISUAL ACUITY: Vision OD is 20/60, OS is 20/20.
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eyevista 521 veces45-year-old man decreased vision in the right eye starting about two days ago. VISUAL ACUITY: Vision OD is 20/60, OS is 20/20.
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eyevista 503 veces45-year-old man decreased vision in the right eye starting about two days ago. VISUAL ACUITY: Vision OD is 20/60, OS is 20/20.
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eyevista 542 veces45-year-old man decreased vision in the right eye starting about two days ago. VISUAL ACUITY: Vision OD is 20/60, OS is 20/20.
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eyevista 683 veces45-year-old man decreased vision in the right eye starting about two days ago. VISUAL ACUITY: Vision OD is 20/60, OS is 20/20.
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45-year-old man was seen in the office on 11/2/2010. He has noticed decreased vision in the right eye starting about two days ago. It was like a shadow in his vision. He is in excellent health. He takes no systemic medications, definitely no steroids, and he has no headaches, tinnitus or problems lately. He does have a little bit of pressure around his sinuses.
VISUAL ACUITY: Vision OD is 20/60, OS is 20/20. IOP: OD 15. There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. There is a serous macular detachment.
OS: Vertical C/D ratio is 0.5. The macula and periphery look normal.
OCT SCAN: The OCT scan of the right eye shows a serous macular detachment.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows a pigment epithelial detachment just inferior to the fovea with leakage later into the serous macular detachment. There is also a small pigment epithelial detachment inferonasal to the serous detachment. The left eye is angiographically normal..
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY WITH SEROUS MACULAR DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient the right eye does have central serous retinopathy and 95% of the time the vision improves and the subretinal fluid absorbs without treatment. Generally though, people do notice things a little smaller in the eye after the subretinal fluid does absorb. There is about a 25% recurrence rate and if the fluid does not absorb over the next three to six months, then it is reasonable to consider therapy. At this moment, probably photodynamic therapy is the most reasonable alternative.
I asked him to return for check in four months, sooner should he notice a problem.
