Last additions - Acute Central Serous Retinopathy - Infra-red image shows area of vision loss 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. You saw fluid in the retina and suggest he come here for an evaluation. 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.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment. As far as we understand from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. 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.
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. I asked him to see you back periodically. I told him in the future unless it is absolutely necessary, he should avoid steroid therapy.
Subsequent visit:
42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. I last saw him for this October 7th. His vision does seem better.
VISUAL ACUITY: OD 20/20. IOP: 13. The lens is clear.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. The fovea looks smooth.
SPECTRALIS-SD-OCT SCAN: The OCT scan confirms an absence of intraretinal or subretinal fluid. The choroidal thickness is 600 microns.
FUNDUS PHOTOGRAPHY - INFRA RED: The image does show where the serous detachment was.
IMPRESSION:
1. RESOLVING CENTRAL SEROUS RETINOPATHY – RIGHT EYE
DISCUSSION: I explained to the patient the eye looks much better. I asked him to see you back regularly. I told him he does not need to return here unless you or he note further problems.
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better - Normal Photo711 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.
VISUAL ACUITY: OD 20/20.
May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better - FAF shows small abnormality777 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.
VISUAL ACUITY: OD 20/20. May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better INFRARED SHOWS EXACT VISION DEFECT716 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.OD 20/20. The patient looked at this infra-red image and said "That's exactly what I see!"May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better - OCT Extended Depth Imaging - Choroidal Congestion587 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.
VISUAL ACUITY: OD 20/20. May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better581 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.OD 20/20. The patient looked at this infra-red image and said "That's exactly what I see!"
VISUAL ACUITY: OD 20/20. May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better601 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.
VISUAL ACUITY: OD 20/20. May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Fellow Eye621 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Fellow Eye562 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Fellow Eye567 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Fellow Eye473 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Fellow Eye447 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Fellow Eye462 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Affected Eye - Choroidal Leakage459 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Affected Eye - Choroidal Leakage458 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Affected Eye - Choroidal Leakage495 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - ICG Affected Eye - Choroidal Leakage667 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Affected Eye488 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Affected Eye487 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - FA Affected Eye618 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision 488 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision 614 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision 513 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
501 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
507 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision 622 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - Fundus Autofluorescence596 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - Fundus HyperAutofluorescence Serous Retinal Detachment827 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. The OCT scan of the right eye confirms subretinal fluid.May 22, 2012
|
|
|
|
|
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. You saw fluid in the retina and suggest he come here for an evaluation. 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.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment. As far as we understand from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. 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.
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. I asked him to see you back periodically. I told him in the future unless it is absolutely necessary, he should avoid steroid therapy.
Subsequent visit:
42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. I last saw him for this October 7th. His vision does seem better.
VISUAL ACUITY: OD 20/20. IOP: 13. The lens is clear.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. The fovea looks smooth.
SPECTRALIS-SD-OCT SCAN: The OCT scan confirms an absence of intraretinal or subretinal fluid. The choroidal thickness is 600 microns.
FUNDUS PHOTOGRAPHY - INFRA RED: The image does show where the serous detachment was.
IMPRESSION:
1. RESOLVING CENTRAL SEROUS RETINOPATHY – RIGHT EYE
DISCUSSION: I explained to the patient the eye looks much better. I asked him to see you back regularly. I told him he does not need to return here unless you or he note further problems.
