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Multimodal imaging for the diagnosis of an atypical case of central serous chorioretinopathy.

Kahloun R, Chebbi A, Amor SB, Ksiaa I, Nacef L, Khairallah M - Middle East Afr J Ophthalmol (2014 Oct-Dec)

Bottom Line: However, visual acuity remained severely impaired in one eye.Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment.Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.

ABSTRACT
We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management.

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Late-phase fluorescein angiogram 3 months later shows resolution of pinpoints in the RE
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F2a: Late-phase fluorescein angiogram 3 months later shows resolution of pinpoints in the RE

Mentions: A diagnosis of chronic CSCR exacerbated by corticosteroids and complicated by retinal neovascularization and subretinal fibrosis in the RE was retained. Corticosteroids were gradually tapered and immunosuppressive therapy was stopped. As photodynamic therapy was not available in our department, a single intravitreal injection of bevacizumab was performed in the RE. Three months later, BCVA remained unchanged (20/400) in the RE and improved to 20/32 in the LE. Intravitreal and preretinal hemorrhage in the RE had resolved, and the retina had reattached. Fluorescein and ICG angiographic features of active CSCR had resolved [Figure 2]. SRD had partially resolved in the RE on OCT.


Multimodal imaging for the diagnosis of an atypical case of central serous chorioretinopathy.

Kahloun R, Chebbi A, Amor SB, Ksiaa I, Nacef L, Khairallah M - Middle East Afr J Ophthalmol (2014 Oct-Dec)

Late-phase fluorescein angiogram 3 months later shows resolution of pinpoints in the RE
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219231&req=5

F2a: Late-phase fluorescein angiogram 3 months later shows resolution of pinpoints in the RE
Mentions: A diagnosis of chronic CSCR exacerbated by corticosteroids and complicated by retinal neovascularization and subretinal fibrosis in the RE was retained. Corticosteroids were gradually tapered and immunosuppressive therapy was stopped. As photodynamic therapy was not available in our department, a single intravitreal injection of bevacizumab was performed in the RE. Three months later, BCVA remained unchanged (20/400) in the RE and improved to 20/32 in the LE. Intravitreal and preretinal hemorrhage in the RE had resolved, and the retina had reattached. Fluorescein and ICG angiographic features of active CSCR had resolved [Figure 2]. SRD had partially resolved in the RE on OCT.

Bottom Line: However, visual acuity remained severely impaired in one eye.Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment.Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.

ABSTRACT
We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management.

Show MeSH
Related in: MedlinePlus