Last additions - Acute Central Serous Retinopathy - Classic Smokestack 34-year-old man was seen in the office on 5/18/2012. He noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting. You saw a problem in the macula and suggested he come here for an evaluation. He is not taking any steroids, nasal inhaler, or any phosphodiesterase inhibitors.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16. IOP: OD 16, OS 14.
SLIT LAMP EXAM: Normal with clear lenses, except the left eye does have a nevus on the lid margin which he says has been there for a long time. It is on the lower lid about a millimeter in size.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is serous macular detachment.
OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. There is lattice degeneration inferiorly.
OCT SCAN: The OCT scan of the right eye shows a serous retinal detachment. The average central foveal thickness is 588 microns.
OCT SCAN: The OCT scan of the left eye is normal.
PHOTOGRAPHS: The photo in the right eye shows a serous macular detachment centrally with some blunting of the retinal reflex. The left eye does show some dilated retinal veins; however, there is no evidence of any macular pathology.
FLUORESCEIN ANGIOGRAPHY: The right eye does show a focal leaky spot just inferior to the fovea, about 500 microns, at the edge of the foveal avascular zone and there is leakage of fluorescein emanating off of the spot superiorly. The FA of the left eye is normal; however, the retinal veins are slightly dilated.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy in the right eye. About 95% of these cases will improve over the course of about a month or two, sometimes taking as long as six months. I asked him, here going forward, to avoid any sort of steroid preparations because that is a contraindication in patients with central serous retinopathy.
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - OCT1406 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1306 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1268 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1300 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1252 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1254 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1338 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1381 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1680 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1501 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1427 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1377 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1342 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1325 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1327 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1314 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1345 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1491 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1412 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - Animated .GIF1402 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - Antimated .GIF1611 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16Sep 05, 2012
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34-year-old man was seen in the office on 5/18/2012. He noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting. You saw a problem in the macula and suggested he come here for an evaluation. He is not taking any steroids, nasal inhaler, or any phosphodiesterase inhibitors.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16. IOP: OD 16, OS 14.
SLIT LAMP EXAM: Normal with clear lenses, except the left eye does have a nevus on the lid margin which he says has been there for a long time. It is on the lower lid about a millimeter in size.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is serous macular detachment.
OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. There is lattice degeneration inferiorly.
OCT SCAN: The OCT scan of the right eye shows a serous retinal detachment. The average central foveal thickness is 588 microns.
OCT SCAN: The OCT scan of the left eye is normal.
PHOTOGRAPHS: The photo in the right eye shows a serous macular detachment centrally with some blunting of the retinal reflex. The left eye does show some dilated retinal veins; however, there is no evidence of any macular pathology.
FLUORESCEIN ANGIOGRAPHY: The right eye does show a focal leaky spot just inferior to the fovea, about 500 microns, at the edge of the foveal avascular zone and there is leakage of fluorescein emanating off of the spot superiorly. The FA of the left eye is normal; however, the retinal veins are slightly dilated.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy in the right eye. About 95% of these cases will improve over the course of about a month or two, sometimes taking as long as six months. I asked him, here going forward, to avoid any sort of steroid preparations because that is a contraindication in patients with central serous retinopathy.
