Title

MULTIPLE RETINAL PIGMENT EPITHELIAL DETACHMENT IN CENTRAL SEROUS CHORIORETINOPATHY

Introduction

Central serous chorioretinopathy (CSC) is characterized by detachment of the neurosensorial retina as a result of the accumulation of serous fluid between the neurosensorial retina and the retinal pigment epithelium. CSC affects more male individuals, aged 20 to 45 years. The disease is observed in patients with a personality described as “type A profile”, characterized by high levels of anxiety. Evidence suggests that CSC occurs due to hyperpermeability and increased hydrostatic pressure within the choroidal circulation, leading to the formation of pigment epithelial detachments (PEDs). In this case report we present an atypical variant that presents multiple PEDs and multiple bullous serous neurosensory detachments that demonstrate shifting fluid.

Methods

Medical records review.

Results

Male, 46 yo, with progressive low visual acuity (VA) in the left eye (OS) four months before visiting the Ophthalmology Department of FMABC. Only eye patient due to trauma. Pathological history showed anxiety and gout. He denies using corticosteroids. At initial ophthalmological examination, VA was no light perception in the right eye and 20/60 in OS. A fundus examination revealed in OS well-defined elevation in the macula and in the superior temporal arch. Optical coherence tomography revealed multiple PEDs. The fluorescein angiography shows an early-phase hyperfluorescence and subretinal pooling. It was opted to adopt oral treatment with spironolactone and monthly follow-up. Best corrected VA improved to 20.25 during follow-up.

Discussion

CSC typically occurs in younger patients and is characterized by decreased and distorted vision, often associated with metamorphopsia, micropsia and reduced contrast sensitivity. We report a rare of CSC, characterized by large, multiple PEDs without subretinal fluid (SRF) as presented in the AGF images, that shows the retinal detachment of the RPE, associated with a mechanical reason due the size of the PEDs and not because of SRF like in a typical case of CSC.

Keywords

Central Serous Chorioretinopathy; Pigment Epithelial Detachments; Retina

Area

CLINICAL CASE

Authors

LARISSA CAROLINE MANSANO SOARES, CAROLINA RODRIGUES BARRETO MENDES, LUCIANO RABELLO NETTO CIRILLO, CRISTINA NERY CARBAJO, PRISCILA NASCIMENTO ALVES, LETICIA FERNANDES MONTEIRO, JULIO ZAKI ABUCHAM NETO, VAGNER LODUCCA LIMA