Acute Central Serous Retinopathy - Fundus Autofluorescence and ICG
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42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 10, OS 15.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a serous retinal detachment temporal to the fovea.
OS: Vertical C/D ratio is 0.1. There are macular pigment spots. There is no subretinal fluid.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye confirms subretinal fluid. The left eye shows no subretinal fluid, but there are areas of pigment epithelial irregularities and there is one under the fovea. Photos confirm clinical findings. The enhanced step imaging of the right eye shows a choroidal thickness centrally of 537 microns and the left eye has 505 microns. These numbers are about double to normal.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows an area of hyperfluorescence superotemporal to the fovea, which minimally leaks in the late frames. The left eye shows some hyperfluorescence centrally, which stains.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram in both eyes shows areas of capillary hyper permeability in the right eye superotemporally and the left eye centrally.
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY – BOTH EYES
2. SEROUS RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy and that 95 percent of patients with this problem do recover vision without any incident. I warned him that sometimes the cases become chronic and they need treatment, but I think since this was probably steroid induced that he should recover over the next few months. I asked him to return in three months. I told him if his vision is fine then though, he doesn’t need to keep the appointment.
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Central Serous Retinopathy Acute vu 1203 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute vu 842 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute vu 780 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute vu 785 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute vu 934 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Enhanced Depth Imaging OCT - Thickened Choriodvu 928 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute vu 827 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Enhanced Depth Imaging OCT - Thickened Choriodvu 1005 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescencevu 1233 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescencevu 1217 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescencevu 1488 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescencevu 1318 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Fundus Autofluorescencevu 1389 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogramvu 1333 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogramvu 1028 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogramvu 1226 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Fluorescein Angiogramvu 877 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1164 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1019 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1621 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(1 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1074 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1086 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1210 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1092 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 951 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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Central Serous Retinopathy Acute - Indocyanine Green Angiogram - Leakage Choriocapillaris vu 1170 fois42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
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42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 10, OS 15.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a serous retinal detachment temporal to the fovea.
OS: Vertical C/D ratio is 0.1. There are macular pigment spots. There is no subretinal fluid.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye confirms subretinal fluid. The left eye shows no subretinal fluid, but there are areas of pigment epithelial irregularities and there is one under the fovea. Photos confirm clinical findings. The enhanced step imaging of the right eye shows a choroidal thickness centrally of 537 microns and the left eye has 505 microns. These numbers are about double to normal.
FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence shows typical hyper auto fluorescence inside the serous macular detachment from shed photoreceptor outer segments, the left eye on the fundus auto fluorescence is nearly normal. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows an area of hyperfluorescence superotemporal to the fovea, which minimally leaks in the late frames. The left eye shows some hyperfluorescence centrally, which stains.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram in both eyes shows areas of capillary hyper permeability in the right eye superotemporally and the left eye centrally.
IMPRESSION:
1. CENTRAL SEROUS RETINOPATHY – BOTH EYES
2. SEROUS RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient he does have central serous retinopathy and that 95 percent of patients with this problem do recover vision without any incident. I warned him that sometimes the cases become chronic and they need treatment, but I think since this was probably steroid induced that he should recover over the next few months. I asked him to return in three months. I told him if his vision is fine then though, he doesn’t need to keep the appointment.
