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 Eye653 views45-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 Eye561 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye758 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye555 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye604 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye558 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye546 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye531 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye479 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye527 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye464 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye527 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye501 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye529 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye509 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye534 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye545 views45-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.
(0 votes)
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Acute Central Serous Retinopathy (Chorioretinopathy) Right Eye689 views45-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.
(0 votes)
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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.
