ACUTE BILATERAL RETINAL AND CHOROIDAL DETACHMENT-A CASE REPORT

To report an unusual episode of acute bilateral retinal and choroidal detachment.

Case report.

We report the case of a 57-year-old man referred to the emergency department for an acute bilateral retinal detachment. He had experienced profound visual loss 3 weeks earlier while hospitalized for sepsis of unknown cause. Fundoscopy revealed bilateral annular retinal and choroidal detachment, confirmed by echography. An extensive workup was negative, and the patient was given steroid boluses for suspected uveal effusion syndrome, although the axial length was normal. After 5 days of steroid treatment, minimal improvement was observed. The treatment was discontinued, and new multimodal imaging revealed a hyperfluorescent spot on fluorescein angiography in the right eye with subretinal hyperreflective material on corresponding optical coherence tomography, suggesting fibrin and adjacent serous detachment. The spot was treated with laser photocoagulation, and the retinal detachment started to decrease 2 days later. Additional hyperfluorescent spots were later found and treated with laser photocoagulation. For a few weeks, both functional and anatomical improvements were observed. During the course of 7 months, the central serous retinal detachment slowly and completely resolved while vision progressively and dramatically improved. This very slow and dramatic anatomical and functional improvement was atypical for both uveal effusion syndrome and central serous chorioretinopathy.

This atypical case of type-3 uveal effusion syndrome presented as acute bilateral retinal and choroidal detachment with central serous chorioretinopathy-like features. Multifocal laser photocoagulation may have improved both functional and anatomical outcomes, with dramatic recovery after 7 months.