Título / Title

MULTIPLE RETINAL PIGMENT EPITHELIAL DETACHMENT IN CENTRAL SEROUS CHORIORETINOPATHY

Introdução / Purpose

Central serous chorioretinopathy (CSC) is a disease that is characterized by detachment of the neurosensorial retina as a result of the accumulation of serous fluid between the neurosensorial retina and the retinal pigment epithelium (RPE). Although the exact pathophysiology of CSC is not yet fully understood, the primary pathology is thought to begin with disruption of the choroidal circulation. In this case report we report an atypical variant of central serous chorioretinopathy (CSC) that presents with multiple PEDs and multiple bullous serous neurosensory detachments that demonstrate shifting fluid.

Material e Método / Methods

Not apply

Resultados / Results

Male, 46-year-old, presented with progressive low visual acuity in the left eye (OS) for four months. Fundus examination revealed in OS circumscribed elevation in the macula and in the superior temporal arch. Optical coherence tomography revealed multiple PEDs retinal detachment of the RPE, associated with a mechanical reason due the size of the PEDs. During patient returns, the patient reports improvement in visual acuity, evolving with 20/25 in OS.

Discussão e Conclusões / Conclusion

CSC typically is characterized by decreased and distorted vision, often associated with metamorphopsia, micropsia, mild dyschromatopsia and reduced contrast sensitivity. Acute CSC is in most cases self-limiting with spontaneous resolution of the subretinal fluid and therefore initially observation is recommended. Treatment options based on case series consist of systemic carbonic anhydrase, mild laser photocoagulation, diode micropulse laser photocoagulation, half dose/half fluence photodynamic therapy , intravitreal injection of VEGF inhibitors among others. We report a rare of CSC, characterized by large, multiple PEDs without SRF as presented in the AGF images, that shows the retinal detachment of the RPE, associated with a mechanical reason due the size of the PEDs and not because of subretinal fluid like in a typical case of CSC.

Palavras Chave

Central serous chorioretinopathy; Optical coherence tomography; retinal pigment epitheliopathy

Area

CLINICAL RETINA