Acute Central Serous Retinopathy - Fundus Autofluorescence and ICG
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42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 10, OS 15.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a serous retinal detachment temporal to the fovea.
OS: Vertical C/D ratio is 0.1. There are macular pigment spots. There is no subretinal fluid.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye confirms subretinal fluid. The left eye shows no subretinal fluid, but there are areas of pigment epithelial irregularities and there is one under the fovea. Photos confirm clinical findings. The enhanced step imaging of the right eye shows a choroidal thickness centrally of 537 microns and the left eye has 505 microns. These numbers are about double to normal.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows an area of hyperfluorescence superotemporal to the fovea, which minimally leaks in the late frames. The left eye shows some hyperfluorescence centrally, which stains.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram in both eyes shows areas of capillary hyper permeability in the right eye superotemporally and the left eye centrally.
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY – BOTH EYES
2. SEROUS RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy and that 95 percent of patients with this problem do recover vision without any incident. I warned him that sometimes the cases become chronic and they need treatment, but I think since this was probably steroid induced that he should recover over the next few months. I asked him to return in three months. I told him if his vision is fine then though, he doesn’t need to keep the appointment.
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Central Serous Retinopathy Acute 1188 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute 833 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute 773 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute 778 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute 929 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Enhanced Depth Imaging OCT - Thickened Choriod921 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute 822 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Enhanced Depth Imaging OCT - Thickened Choriod993 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescence1221 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescence1204 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescence1474 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescence1306 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescence1380 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogram1323 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogram1019 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogram1219 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogram870 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1156 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1013 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1615 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1069 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1079 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1203 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1072 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 943 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris 1159 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 10, OS 15.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a serous retinal detachment temporal to the fovea.
OS: Vertical C/D ratio is 0.1. There are macular pigment spots. There is no subretinal fluid.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye confirms subretinal fluid. The left eye shows no subretinal fluid, but there are areas of pigment epithelial irregularities and there is one under the fovea. Photos confirm clinical findings. The enhanced step imaging of the right eye shows a choroidal thickness centrally of 537 microns and the left eye has 505 microns. These numbers are about double to normal.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows an area of hyperfluorescence superotemporal to the fovea, which minimally leaks in the late frames. The left eye shows some hyperfluorescence centrally, which stains.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram in both eyes shows areas of capillary hyper permeability in the right eye superotemporally and the left eye centrally.
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY – BOTH EYES
2. SEROUS RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy and that 95 percent of patients with this problem do recover vision without any incident. I warned him that sometimes the cases become chronic and they need treatment, but I think since this was probably steroid induced that he should recover over the next few months. I asked him to return in three months. I told him if his vision is fine then though, he doesn’t need to keep the appointment.
