Internal drainage for chronic macula-involving serous retinal detachment in idiopathic central serous chorioretinopathy

Abstract

Conventional treatment of idiopathic central serous chorioretinopathy (ICSC) consists of argon laser, photodynamic therapy, or observation. However, in cases of atypical bullous ICSC with exudative detachment preventing any laser therapy, a surgical approach with external drainage of fluid has been performed. We present a case of ICSC with persistent macula involving exudative retinal detachment without evidence of uveitis that responded favorably to internal drainage by vitrectomy along with a scleral buckle placement. Our case, treated with internal drainage, also demonstrated successful long-term reattachment of the serous retinal detachment without any additional complications from the surgery.

Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

“…He obtained a complete SRF resolution the day after surgery and a BCVA of 20/80 with no recurrence at six-months of follow-up [ 14 ]. Even if the external drainage techniques avoid the risks related to intraocular surgery, carry the threat of subretinal or choroidal hemorrhages [ 38 ].…”

“…About internal drainage techniques (pars plana vitrectomy, scleral buckling with cryopexy and retinotomy) have been successfully employed in RD associated to uveitis and may ensure to remove all subretinal fluid [ 27 , 38 , 39 , 40 ]. Nevertheless, these treatments often have been reported as a result of misdiagnosed bCSCR [ 14 ].…”

“…John et al performed an encircling scleral buckle, phacoemulsification and 20-gauge pars plana vitrectomy in a patient affected by bCSCR with BCVA of 20/80 [ 38 ]. SRF was drained trough a superior retinotomy, then endolaser on 360° and silicone oil tamponade were applied.…”

“…SRF was drained trough a superior retinotomy, then endolaser on 360° and silicone oil tamponade were applied. One year later, the silicone oil was removed, OCT showed no SRF but minimal intraretinal fluid and BCVA was 20/200 [ 38 ].…”

Photodynamic therapy for bullous retinal detachment: a single-center experience of case series with a 6-month follow-up study

“…Some cases also indicated that transpupillary thermotherapy seemed to be effective for the treatment of bullous variant of CSC in the short term and internal drainage could lead to anatomical and functional improvement [13, 14]. In fact, the treatment for bullous retinal detachment has not been well established.…”