Atypical Central Serous Chorioretinopathy with Bilateral Bullous Exudative Retinal Detachment Following Systemic Corticosteroid Therapy

Entezari, Morteza

doi:10.15226/2474-9249/2/1/00119

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“…Several cases of CSR were reported after administration of systemic corticosteroids. 4,11 The presence of serous retinal detachment is most easily detected by clinical examination using indirect ophthalmoscopy, unless obstructed by hazy ocular media. Initial examination should include careful evaluation for retinal breaks or tractional membranes.…”

Section: Case Presentationmentioning

confidence: 99%

“…It is known that longstanding CSR can cause severe vision loss due to significant photoreceptor damage and ultimately lead to the formation of subretinal fibrotic scars and foveal scaring.Multiple therapeutic approaches have been described for treating BERD, which mainly involves laser photocoagulation or surgical drainage. However, Nishikawa, et al8 and Entezari, et al11 have reported some cases of BERD resolved completely without any treatment. Another treatment that has recently proven to be useful in chronic CSR is the administration of mineralocorticoid antagonist, known as eplerenon 12.…”

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confidence: 99%

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Surgical Treatment of Bilateral Bullous Exudative Retinal Detachment Following Systemic Corticosteroid Therapy: A Case Report from Aceh

Zaini

2022

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Introduction: Exudative retinal detachment refers to elevation of the neural retina caused by subretinal fluid accumulation in the absence of a retinal break or significant preretinal traction. Management of exudative retinal detachment should include management of the underlying disease. When the fluid is not resolved, surgical intervention is planned after failure of conventional treatment. We demonstrated the successful surgical management of exudative bullous retinal detachment using the internal drainage technique. Case Presentation: A 45 years old man presented with complaint of blurred vision since 5 months before admission. Worsening occurred mainly after administration of high dose methylprednisolone infusion therapy. Visual acuity of the right eye was hand motion, and left eye was 1 meter finger counting. Fundus examination revealed exudative bullous retinal detachment in both eyes. Discussion: Surgery can be considered as a treatment of choice for exudative retinal detachment if medical management is unsuccessful. A complete examination to determine the cause of the disease is needed before carrying out surgery. External and internal drainage techniques have been reported to be successful in managing subretinal fluid in chronic exudative retinal detachment. We chose vitrectomy with internal drainage because large amount of dense subretinal fluid can make transscleral drainage very difficult. Conclusions: Surgical management (vitrectomy with internal drainage) can provide good results in chronic exudative retinal detachment, but should not be used as first-line therapy.

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Section: Case Presentationmentioning

confidence: 99%

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confidence: 99%