Bullous variant of idiopathic central serous chorioretinopathy

Abstract

Background-Spontaneous bullous serous retinal detachment (RD) with subretinal exudation complicating idiopathic central serous chorioretinopathy (ICSC) is a rare and infrequently described clinical entity. Clinical observations are described on this variant form in 11 patients, the largest series reported to date. Methods-13 eyes of 11 Indian patients having this entity were followed up clinically and angiographically for 12-24 months (retrospective, longitudinal). None of the patients had any previous history of other diseases nor were they on any medications. Four eyes received laser treatment (group A); nine eyes were not treated (group B). Results-All

Atypical Central Serous Chorioretinopathy with Bilateral Bullous Exudative Retinal Detachment Following Systemic Corticosteroid Therapy

“…Similar presentations have also been reported previously [3,5,7]. In some of these reports however, subretinal fibrosis was developed in the course of the disease [3,5]. Nonetheless, our patient improved completely over a period of 6 months without any apparent subretinal fibrosis.…”

“…Absence of vitreous cells, presence of yellow-white lesions with single or multiple pigment epithelial detachments, shifting fluid with fluctuating vision, and absence of retinal break may lead us to differentiate it from other similar diseases. In addition, FA and ICG as well as OCT are essential ancillary tests to confirm the diagnosis [3].…”

“…are among the atypical forms of ICSC presentations [2][3][4]. This atypical presentation following systemic corticosteroid therapy may be complicate diagnosis of ICSC [5,6].…”

Central serous chorioretinopathy: an update on pathogenesis and treatment

“…Owing to its peculiar clinical findings, it can present a diagnostic dilemma and may lead to inappropriate diagnosis of rhegmatogenous RD or serous RD because of other causes. 115 Corticosteroid therapy, organ transplantation, haemodialysis, and pregnancy have been reported to relate to this form of CSC. It has been described however as an idiopathic CSC form as well.…”

“…[116][117][118] In the largest case series of ICSC with spontaneous bullous exudative RD, visual prognosis was good without any treatment. 115 Photoreceptor atrophy in the fovea, despite successful reattachment, occurs after duration of symptoms of approximately 4 months. 47 Attenuation of the foveal photoreceptor layer is associated with permanent visual loss as mentioned above.…”