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Top rated - 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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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.
