Acute Bilateral Central Serous Retinopathy - Bullous Serous Retinal Detachment
|
|
49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 812 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 674 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 644 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 648 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 815 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 805 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 743 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 607 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 693 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 663 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 516 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 576 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 531 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 580 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 514 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 495 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 467 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 430 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 462 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 428 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 412 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 459 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 458 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 441 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 450 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 474 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 443 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 421 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 575 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(1 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 432 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute vu 402 fois49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 513 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 427 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 551 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OUvu 583 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute - 4 months later VA 20/40 OUvu 681 foisNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
|
|
49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
