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Persistent Subretinal Fluid in a Case With Central Serous Chorioretinopathy and Progressive Retinal Changes: An
Ryoh Funatsu1, Naohisa Mihara1, Hiroto Terasaki1
1Department of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan, kagoshima-u.ac.jp.
Introduction:
This study is aimed at reporting detailed longitudinal changes in best-corrected visual acuity (BCVA) and retinal structure in a patient with central serous chorioretinopathy (CSC) and persistent serous retinal detachment over one and a half years.
Case Report:
A man in his 40s presented with unilateral mild vision loss. On the initial examination, the BCVA was 20/25 OS. Optical coherence tomography (OCT) revealed macular serous retinal detachment, and fluorescein angiography identified two focal leakage spots within this area, leading to the diagnosis of CSC. Despite the persistence of serous retinal detachment after several focal photocoagulations, the patient refused photodynamic therapy, which resulted in the serous retinal detachment remaining for 18 months. In the affected eye, the BCVA and outer nuclear layer (ONL) thickness were initially 20/25 and 86 μm, respectively. These values subsequently deteriorated to 20/67 and 73 μm at 6 months and further decreased to 20/200 and 46 μm at 18 months. The reflectivity of the photoreceptor layer progressively increased, leading to the formation of intraretinal hyperreflective foci 18 months from baseline.
Conclusions:
A patient with CSC and persistent serous retinal detachment may present a relatively rapid decline in BCVA and progressive retinal damage. The chronicity of CSC is associated with specific structural findings, such as thinning of the ONL and photoreceptor layer and increased photoreceptor reflectivity leading to intraretinal hyperreflective foci.
