Atlas of Ophthalmology

Central Serous Chorioretinopathy (Colour Photography Posterior Segment, Fluorescein Angiography, OCT)

Retina -> Enfermedades Maculares Adquiridas -> Coriorretinopatía Central Serosa Idiopatica (CRCS)
Patient: 45 years of age, male, BCVA 0.6. Ocular Medical History: decreased visual acuity and shadow since 3 days. General Medical History: allergy for penicillin. Main Complaint: blurry vision. Purpose: to present classic ‘smokestack’ appearance of central serous chorioretinopathy. Methods: Colour Photography Posterior Segment, SD-OCT, Fluorescein Angiography . Findings: Colour Photography Posterior Segment: showing neurosensory detachment of most of the macula. OCT: revealing a large amount of subretinal fluid with a regular external limiting membrane. FFA: showing focal leakage inferotemporal to the fovea with progressive expansion of hyperfluorescence from the site of leakage and pooling of fluorescein in the area of retinal detachment as classic ‘smokestack’ appearance of central serous chorioretinopathy. Discussion: Central serous chorioretinopathy (CSC) is characterized by serous detachment of the neurosensory retina in the posterior pole, and diffuse decompensation of the retinal pigment epithelium (RPE). The exact pathophysiology of CSC remains unknown (1). It was shown hyperpermeable choroidal vessels, and thickened choroidal tissue in CSC, suggesting choroidal vasculopathy as a direct cause of CSC. CSC has been described in patients with endogenously high levels of corticosteroids as well as in patients with hypercortisolism due to the treatment of ocular or systemic diseases. Literature: (1) Gemenetzi M, De Salvo G, Lotery AJ. Central serous chorioretinopathy: an update on pathogenesis and treatment. Eye (Lond). 2010 Dec;24(12):1743-56.

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