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Last Month’s Blink

Central Serous Chorioretinopathy With Subretinal Fibrin

Written by Mark J. Daily, MD. Photo by George Henry, CRA. Both are at Wheaton Eye Clinic, Wheaton, Ill.

A 37-year-old man presented with reduced vision in the right eye for two weeks (Fig. 1). VA was 20/70 in the right eye and 20/40 in the left. OCT showed subretinal fluid and a bacillary layer detachment in the right eye (Fig. 2A). Fluorescein angiography demonstrated a single point of rapid dye leakage (Fig. 2B) consistent with central serous chorioretinopathy (CSCR). Focal areas of pigment mottling were present in the left macula without subretinal fluid. While exogenous and endogenous steroids are known to be risk factors for CSCR, the patient was healthy and was taking no medications, including steroids. Testing for hypercortisolism was negative. The patient was treated with photodynamic therapy with verteporfin and thermal laser. Six months later, the subretinal fluid and fibrin had resolved, but VA in the right eye was 20/200 due to subretinal fibrosis.

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