Last additions - Central Serous Retinopathy - Pinpoint Leak I saw this pleasant 37-year-old man in the office on March 4, 2008. He has noticed decreased vision in the left eye since around February 14th. He has started on a nasal inhaler for his allergies, which is Veramyst, which is a steroid inhaler. He may have started that before the vision loss. He is not sure. It is a new medication.
VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 13, OS 15.
SLIT LAMP EXAM: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.3 There is no posterior vitreous separation. There is serous macular detachment.
OCT SCAN: The OCT from your office shows a serous macular detachment in the left eye. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: Shows a leaky spot just inferior to the foveal avascular zone in the left eye. I checked his blood pressure and it was 130/80.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – LEFT EYE
2. POSSIBLE STEROID-INDUCED CENTRAL SEROUS RETINOPATHY – LEFT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy in the left eye. This is sometimes related to steroid use. I suggested he stop the inhaler. I asked him to return for a check in three months, sooner should he notice any problem. He will see you back periodically. I assured him there is a 95% chance the retinal swelling will subside on its own without any need for therapy, but I warned him there is a 25% recurrence rate.
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Central Serous Retinopathy632 viewsOCT scan showing serous RDOct 24, 2010
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Central Serous Retinopathy594 viewsFundus photo showing serous RDOct 24, 2010
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Central Serous Retinopathy633 viewsEarly FAOct 24, 2010
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Central Serous Retinopathy620 viewsLater FAOct 24, 2010
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Central Serous Retinopathy701 viewsRed Free photoOct 24, 2010
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I saw this pleasant 37-year-old man in the office on March 4, 2008. He has noticed decreased vision in the left eye since around February 14th. He has started on a nasal inhaler for his allergies, which is Veramyst, which is a steroid inhaler. He may have started that before the vision loss. He is not sure. It is a new medication.
VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 13, OS 15.
SLIT LAMP EXAM: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.3 There is no posterior vitreous separation. There is serous macular detachment.
OCT SCAN: The OCT from your office shows a serous macular detachment in the left eye. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: Shows a leaky spot just inferior to the foveal avascular zone in the left eye. I checked his blood pressure and it was 130/80.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – LEFT EYE
2. POSSIBLE STEROID-INDUCED CENTRAL SEROUS RETINOPATHY – LEFT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy in the left eye. This is sometimes related to steroid use. I suggested he stop the inhaler. I asked him to return for a check in three months, sooner should he notice any problem. He will see you back periodically. I assured him there is a 95% chance the retinal swelling will subside on its own without any need for therapy, but I warned him there is a 25% recurrence rate.
