Central serous choroidopathy with bullous retinal detachment

Abstract

We report here a new type of secondary retinal detachment that has never been clearly defined. The characteristic features of the disease are: (1) prevalence in middle-aged males, (2) bilateral involvement, (3) frequent existence of prodromal lesions that over long periods resemble central serous retinopathy, (4) in the evolution stage, appearance of multiple yellowish white exudative flecks of one-half to one disc in diameter at or near the posterior pole of the fundus, (5) fluorescein studies revealing pronounced leakage of dye from the choroid into the subretinal space at the sites of exudates, (6) retinal detachment of various degrees with shifting subretinal fluid and without tears, (7) no evidence of intraocular inflammation, (8) no filling abnormalities seen in the choroidal fluorescence, (9) no response to medical therapy, including steroids and antibiotics, (10) photocoagulation to leakage sites leading to rapid resolution of retinal detachment; otherwise, spontaneous healing of detachment occurring within about 7-9 months, leaving fibroblastic macular scars and marked visual loss, and (11) no evidence of systemic findings that may be of etiologic significance. From this characteristic clinical picture, the idea of a new clinical entity must be considered. Our findings in 35 eyes from 18 Japanese patients are discussed.

Bullous retinal detachment in diffuse retinal pigment epitheliopathy

“…A few other cases are reported in the literature [3,4,5] and appear to have the same clinical features and evolution as ours. The gravitational involvement of the lower retinal quadrants in the course of D R P E has been described [1,6].…”

Seröz Maküla Dekolmanları

“…1 Daha sonraki yıllarda seröz maküla dekolmanının yoğun bir şekilde yaşa bağlı maküla dejenerasyonu, santral seröz koryoretinopati ve Vogt Koyanagi Harada (VKH) hastalığında kullanıldığı görülmektedir. [2][3][4] OCT'nin klinik kullanıma girmesi seröz maküla dekolmanı açısından önemli bir miad olmuştur. O güne kadar sadece klinik muayene ve flöresein anjiografi teknikleri ile tanımlanan ve büyük bir çoğunluğu atlanan bu küçük dekolmanlar OCT'nin sağladığı tomografik kesitler sayesinde tanınır hale gelmiştir.…”

“…Tıpkı diabetik retinopati de olduğu gibi klinik tablonun uzun yıllardan beri tanımlanmasına rağmen retina ven dal tıkanıklığında seröz maküla dekolmanı varlığı ancak 2003 yılında gösterilmiştir. 4 Spaide ve ark. 13 OCT kullanarak %71 oranında olguda seröz maküla dekolmanı varlığını göstermiştir.…”

Surgical Management of Exudative Retinal Detachment Associated with Central Serous Chorioretinopathy

“…Treatment of CSC with systemic corticosteroids is ineffective and may, in some cases, exacerbate the disease. Profound visual loss develops in these patients in one or both eyes because of bullous exudative retinal detachment [2][3][4][5][6]. Surgical management of bullous retinal detachment includes transscleral drainage of subretinal fluid and fluid or air injections through the pars plana with photocoagulation to leakage points [7].…”