Severe bilateral central serous chorioretinopathy in a black patient: 16 years follow-up.

PURPOSE

To describe the exceptionally severe, bilateral, sight-compromising course of central serous chorioretinopathy (CSC) in a black patient.

DESIGN

Observational case report.

METHODS

We reviewed the clinical and angiographic findings of a 50-year-old black male patient with severe bilateral chronic CSC.

RESULTS

The first attack was recorded 16 years earlier and it was asymmetrical. In OD, only retinal pigment epithelium (RPE) alterations were detected, while in OS there was a large serous retinal detachment with two smaller RPE detachments. Visual acuity (VA) was 1.0 OD and 0.6 OS. Gradually, after multiple remissions and exacerbations, a huge area of atrophy occupied the posterior pole OS, leading to a dramatic decrease of VA (0.02). The lesions also progressed and remained active in OD (VA 0.2).

CONCLUSIONS

CSC can be exceptionally severe, non-benign, sight-compromising, with multiple remissions and exacerbations during the lifetime. Indocyanine-green angiography is useful for the long-term follow-up in severe cases, showing lesions that are not obvious in fluorescein angiography or funduscopy.