Surgical Management of Exudative Retinal Detachment Associated with Central Serous Chorioretinopathy

Adán, Alfredo; Corcóstegui, Borja

doi:10.1159/000050831

Cited by 8 publications

(13 citation statements)

References 6 publications

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“…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 ].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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Bullous central serous chorioretinopathy (bCSCR) is a rare variant of the central serous chorioretinopathy, complicated by an exudative retinal detachment with shifting fluid. This systematic review aims to present the epidemiology, the pathogenesis, the clinical presentation, the imaging, the differential diagnosis, and the latest treatments of this disease. A total of 60 studies were identified following a literature search adhering to PRISMA guidelines. After full-text evaluation, 34 studies about bCSCR were included. bCSCR usually affects middle-aged men, and the principal risk factor is corticosteroid medications. Pathogenesis is related to an increased choroidal vessel and choriocapillaris permeability, with subsequent subretinal fluid accumulation, rich in fibrin, which may provoke the exudative retinal detachment. Clinical presentation and imaging are fundamental to distinguish bCSCR from other pathologies, avoiding unappropriated treatment. Corticosteroid withdraws (if assumed) and laser photocoagulation of leakage sites seen at angiography may speed up retinal reattachment. Verteporfin photodynamic therapy, transpupillary thermal therapy, oral eplerenone and scleral thinning surgery are other therapeutic options. An early diagnosis might prevent disease progression due to harmful medications as well as unnecessary surgery.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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“…However, when the RD is bullous (as was this case), the subretinal fluid can interrupt the available treatment, meaning that the subretinal fluid should be drained in order to carry out the appropriate therapy. Previously reported cases introduced different techniques for subretinal fluid drainage 12,20. The simplest technique is an external drainage through the sclera in the inferior area.…”

Section: Discussionmentioning

confidence: 99%

“…Several problems also have been pointed out concerning this method, such as reopening of the retinotomy itself, as well as the difficulties already mentioned with visualization with air in the vitreous cavity. Adán and Corcóstegui20 presented a new surgical technique for the treatment of exudative retinal detachment associated with CSC; this includes pars plana vitrectomy, injection of perfluorocarbon liquid (PFCL) with transscleral drainage, and endolaser photocoagulation to leakage points. According to their report, this approach has some advantages, such as complete intraoperative reapplication of the retina and intraoperative laser photocoagulation due to excellent visualization through the PFCL without requiring a drainage retinotomy.…”

Section: Discussionmentioning

confidence: 99%

“…If it persists, laser treatment to focal leaks outside the foveolar area is effective in resolving the detachment 1-8. On rare occasions, a bullous exudative RD, usually associated with multiple large retinal pigment epithelial detachments there are often hidden beneath a cloudy subretinal serofibirnous exudate, may occur in patients with CSC 4-20. This atypical CSC may be misdiagnosed as Vogt-Koyanagi-Harada (VKH) syndrome, uveal effusion, multifocal choroiditis, metastatic carcinoma, or lymphoma because of the combined bullous retinal detachment (RD).…”

mentioning

confidence: 99%

“…It is very unusual for the deposition of fibrin to be followed by fibrotic scar formation 4,9-12,15-17,19-20. So far, 25 cases have been reported in the Korean literature in which bullous exudative RD developed spontaneously in association with CSC; only one of them presented with subretinal fibrotic band formation with permanent visual loss 4-6,19…”

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confidence: 99%

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Surgical Management of Bilateral Exudative Retinal Detachment Associated with Central Serous Chorioretinopathy

Kang

Kim

Boo

et al. 2006

Korean J Ophthalmol

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PurposeTo report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy (CSC) which was attached by vitrectomy and internal drainage of the subretinal fluid.MethodsA 47-year-old man affected by bilateral atypical CSC with a bullous retinal detachment with subretinal exudate. A fluorescein angiogram (FAG) showed multiple points of leakage and staining of subretinal fibrosis. A tentative diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome was made and the patient was treated with systemic corticosteroids and immunosuppressive agents. However, the subretinal fluid was not absorbed. He was then treated with vitrectomy and internal drainage of subretinal fluid.ResultsThe retina was attached successfully in both eyes. Visual acuity improved to 20/50 in his left eye but did not improve in the right eye due to subretinal fibrotic scarring and atropic changes on the macula.ConclusionsOur case suggests that the surgical management of bullous exudative retinal detachment is safe and necessary.

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

2013

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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.

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Surgical Management of Exudative Retinal Detachment Associated with Central Serous Chorioretinopathy

Cited by 8 publications

References 6 publications

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

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

Surgical Management of Bilateral Exudative Retinal Detachment Associated with Central Serous Chorioretinopathy

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

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