Título / Title

BILATERAL MULTIFOCAL CENTRAL SEROUS CHORIORETINOPATHY WITH PACHYCHOROID SECONDARY TO INTRAMUSCULAR CORTICOID: A CASE REPORT

Introdução / Purpose

Report a bilateral multifocal serous chorioretinopathy secondary to the acute use of intramuscular steroids

Material e Método / Methods

OPTICAL COHERENCE TOMOGRAPHY, OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND FLUORESCENTE RETINOGRAPHY

Resultados / Results

Male patient, caucasian, 37 years was seen at the emergency room for acute visual blurring and reported using intramuscular corticosteroids for one week ago. At the ophthalmologic exam, he presented corrected visual acuity of 20/50 in the right eye and 20/60 in the left eye. There were no changes in the biomicroscopic examination, and the intraocular pressure was 14 mmHg at 8:15 in both eyes. Indirect binocular ophthalmoscopy visualized serous retinal detachement and detachement of retinal pigment epithelium in both eyes. Fluorescein angiography showed leakage type hyperfluorescence due to serous retinal detachment of the right eye and polling type hyperfluorescence due to EPR detachment of the left eye (photo 1 and 2). Optical coherence tomography showed detachment of the pigmented epithelium with serous retinal detachment in addition to pachychoroid in both eyes. (photo 3 and 4).

Discussão e Conclusões / Conclusion

Central serous chorioretinopathy (CSC) is an idiopathic and multifactorial disease characterized by a serous detachment of the sensorineural retina at the posterior pole due to the accumulation of serous fluid between the sensorineural retina and retinal pigment epithelium (RPE). It often affects more men in the 4-5th decade of life. It is very associated with the use of corticosteroids, endogenous hypercortisolism and emotional stress. Usually, the acute form is self-limited with spontaneous resolution in about 3-4 months. However, the chronic form may present some complications, such as choroidal neovascularization, cystoid macular edema, sub-retinal lipid deposits and choriocapillar atrophy, which should be identified and treated early, as they may cause severe and irreversible central visual loss.

Palavras Chave

Central serous chorioretinopathy; detachement of retinal pigment epithelium; pachychoroid; OCT A; intramuscular corticoid