Título / Title

ATYPICAL CENTRAL SEROUS CHORIORETINOPATHY ON A 63 YEARS OLD FEMALE PATIENT

Introdução / Purpose

To report the atypical presentation of a central serous chorioretinopathy on a elderly female patient.

Material e Método / Methods

Case report of one patient

Resultados / Results

TCRG, 63 years old female patient, presented with loss of visual acuity (20/60) on her right eye three days prior to the consultation.
She had a stressing month and was on sleep pills. Due to muscular pain, she was given corticosteroid intramuscular injection one month prior to the visit.
She was pseudophakic, and her medical and ocular history was otherwise unremarkable.
Optical coherence tomography of the right eye showed extensive subrretinal fluid on the macula with small retinal pigment epithelium detachments. Fluorescent angiography revealed few leakage points with no signs of choroidal neovascularization. Optical coherence tomography angiography did not reveal any choroidal or retinal neovessels. Pachychoroid was present on both eyes.
Patient was treated with spironolactone 50mg/day with improvement of visual acuity and progressive regression of the subrretinal fluid.
Best corrected visual acuity was 20/25 on her last visit.

Discussão e Conclusões / Conclusion

Central serous chorioretinopathy is uncommon on elderly patients, although females are tipically older on presentation. Sudden loss of visual acuity with pigment epithelium detachment and extensive subrretinal fluid may suggest the diagnosis of choroidal neovascularization, specially on older patients. A throughout examination including optical coherence tomography, fluorescein angiography, indocyanine green angiography and optical coherence tomography angiography is recommended to rule out choroidal neovascularization in these cases.

Palavras Chave

Central serous chorioretinopathy, optical coherence tomography, optical coherence tomography angiography