Atypical Central Serous Chorioretinopathy With Choroidal Detachment: A Case Report

Manayath, George J; Kuthirummal, Nikhil; Ranjan, Ratnesh; Verghese, Shishir; Narendran, Venkatapathy

doi:10.1097/icb.0000000000001065

Cited by 2 publications

(3 citation statements)

References 9 publications

(36 reference statements)

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“…The right eye with submacular fluid and choroid was initially suspected of having severe CSC. Photodynamic therapy has been reported to be effective not only for chronic CSC [7] but also for CSC with choroidal detachment [8]. We therefore performed photodynamic therapy for the fluorescent leakage in the right eye.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Pachychoroid disease with type 3 Uveal effusion syndrome in one eye and central serous Chorioretinopathy in contralateral eye: a case report

et al. 2022

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Background We report a case of bilateral pachychoroid disease with type 3 uveal effusion syndrome (UES) in one eye and central serous chorioretinopathy (CSC) in the contralateral eye. Case presentation A 65-year-old man presented to our department because of decreased vision. Visual acuity was 16/20 in the right eye and 2/20 in the left eye, with normal axial lengths. The left eye was diagnosed with CSC and underwent photocoagulation 8 years ago. The right eye showed inferior non-rhegmatogenous retinal detachment and peripheral choroidal detachment. Macular optical coherence tomography showed submacular fluid in the right eye, pachychoroid in both eyes, and choroidal thickness of 565 μm in the right and 545 μm in the left eye. In both eyes, fluorescence angiography showed window defects and mild fluorescence leakage, and indocyanine green angiography showed dilated choroidal vessels, mild choroidal hyperpermeability, and mild dye leakage. The left eye was diagnosed with chronic CSC. Initially, chronic CSC was also suspected in the right eye. However, photodynamic therapy failed, with worsened retinal detachment and visual acuity. Pachychoroid in the peripheral fundus (choroidal thickness 820 μm) was observed only in the right eye. Based on these findings, UES was diagnosed in the right eye. Sclerectomies were performed. The absence of scleral thickening and glycosaminoglycan deposition led to a final diagnosis of type 3 UES. The procedure was not effective, due to connective tissue regeneration at the sclerectomy sites. In the revision surgery, mitomycin-C was used with sclerectomies. One month after surgery, retinal and choroidal detachment disappeared, visual acuity recovered to 8/20, pachychoroid in the macula and peripheral fundus decreased, and choroidal thickness decreased to 352 μm in the macula and 554 μm in inferior peripheral fundus. Conclusions Pachychoroid in the posterior pole was the common finding in type 3 UES and CSC, although extensive pachychoroid in the peripheral fundus may have caused retinal and choroidal detachment in the eye with type 3 UES. Full-thickness sclerectomies with mitomycin-C improved pachychoroid in the peripheral fundus and resolved retinal and choroidal detachment, clearly indicating that the sclera was the main cause of type 3 UES.

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Section: Discussionmentioning

confidence: 99%

Bilateral Pachychoroid disease with type 3 Uveal effusion syndrome in one eye and central serous Chorioretinopathy in contralateral eye: a case report

et al. 2022

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“…There are a limited number of case reports describing the relationship between CE and CSC. All case reports have described atypical CSC cases, especially those with inferior bullous retinal detachment 23,24 or those acquiring CSC after intraocular surgery. 25 Ciliochoroidal effusion with CSC observed in the current study was more limited or milder than that in UES.…”

Section: Discussionmentioning

confidence: 99%

“…14 Therefore, we postulated that a thickened sclera, similar to the UES pathologic assessment, possibly disturbs the choroidal venous outflow and reduces the transscleral fluid outflow. 14 Uveal effusion syndrome eyes share many characteristics with CSC eyes, such as a short axial length, 9 scleral thickening, 14 choroidal thickening, 28 SRD, and CE, 23 although to different degrees. The current study showed that anterior scleral thickness of the CE group was significantly greater than that of the non-CE group at the superior, temporal, inferior, and nasal points.…”

Section: Discussionmentioning

confidence: 99%