Central serous chorioretinopathy and bullous retinal detachment: a rare association

While idiopathic central serous retinopathy (ICSC) is a common ocular condition, bullous exudative retinal detachment associated with ICSC is a relatively rare finding. Bullous retinal detachment has been described as a severe variant of ICSC, characterised by multiple leaking pigment epithelial detachments and the presence of shifting neuro-sensory sub-retinal fluid. The peculiar clinical findings may present a diagnostic dilemma and lead to inappropriate treatment. Here, we describe the atypical presentation of ICSC with bullous retinal detachment and the effect of focal laser treatment on resolution of the retinal detachment. Despite ICSC being a self-limiting condition in the majority of cases, recognition of this atypical form of ICSC is important. Failure to differentiate this condition from inflammatory disease of the retina and choroid may result in inappropriate use of corticosteroids, leading to exacerbation of the condition and permanent visual loss.