Ali Osman Saatci, Aylin Yaman, Meltem Soylev, Berker Memisoglu.
An atypical presentation of Central Serous Retinopathy.
Pak J Ophthalmol Jan ;13(4):124-6.

Central serous retinopathy with bullous retinal detachment is a very rare type of central serous retinopathy characterized by extensive sensory retinal detachment of the posterior pole and/or elsewhere. we describe a 26 year-old woman with bilateral central serous retinopathy who had bilateral bullous retinal detachment with serious visual loss. A short-term oral steroid therapy was commenced (1mg/kg/day). No angiographic clue was demonstrable six months later and visual acuity returned to a level of 20/20 bilaterally.

CASE REPORT: A 26-year-old housewife complained of decreased vision for four days in her left eye. Her past medical and ocular history was unremarkable. Her best corrected visual acuity was 20/20 OD and 20/30 OS. Versions were full and Marcus-Gunn pupil was absent. Slit-lamp examination was unremarkable and applanation pressure was 16 mmHg bilaterally. Ophthalmoscopy of the left eye disclosed an area of opaque, edematous elevated retina involving the macula and peripapillary area, while the right fundus appeared normal. Fluorescein angiogram revealed multiple enlarging hyperfluorescent points consistent with retinal pigment epithelium detachments with profuse late fluorescein leakage. A diagnosis of central serous retinopathy with bullous detachment was made. At the time of presentation no therapy was given. A week later she returned with further decreased vision in both eyes. Visual acuity was 20/40 OD and counting fingers OS. On funduscopy, there was also bullous retinal detachment involving the macula and peripapillary region in OD. Perimetric evaluation clearly delineated the large cecocentral scotoma in both eyes. She was put on 60mg prednisolone (lmg/kg/day) with a rapid tapering in three weeks. Her vision was 20/20 OD and 20/40 OS three weeks later and it was 20/20 OU without any angiographical findings six months later.

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