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 840 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 672 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 833 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 831 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 753 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 623 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 739 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 680 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 538 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 598 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 555 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 606 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 547 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 511 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 496 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 446 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 482 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 445 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 437 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 471 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 487 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 484 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 486 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 471 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 469 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 625 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 451 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 4 months later VA 20/40 OUvu 540 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 446 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 580 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 617 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 712 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.
