Central serous retinopathy. A generalized disease of the pigment epithelium

Among cases of central serous retinopathy, patients have been isolated with retinal pigment epithelial (RPE) and sensory retinal detachments. An analysis of 104 cases occurring during the period from 1972 to 1977 indicates that this disorder is frequently bilateral and that it is associated with different disturbances of the epithelial cell layer, i.e. foci of leakage, transmission defects and serous detachments. Based upon the angiographic studies in 76 cases, we propose the following classification for cental serous retinopathy: I. Unilateral Retinopathy. (A) Uniocular involvement: (1) with focal leakage but no other RPE changes; (2) with focal leakage and other RPE changes; (3) with focal leakage, RPE changes and an exudative retinal detachment. (B) Binocular involvement: (1) mild; (2) moderate; (3) severe (with an exudative retinal detachment in the affected eye). II. Bilateral Retinopathy. (A) Mild; (B) moderate, (C) severe (in association with bilateral exudative retinal detachments). This classification emphasizes the fact that central serous retinopathy, whatever its etiology, represents a generalized affectation of the pigment epithelium and should be construed as a potentially serious disorder requiring thorough evaluation and follow-up care.