[Course and prognosis of serous detachment of the retinal pigment epithelium].

In a 15-year retrospective study the spontaneous evolution of serous detachment of the pigment epithelium was investigated functionally, by perimetry, biomicroscopically, and angiofluorographically, in order to identify the manifestations of this syndrome and determine its prognosis. Serous detachments of the retinal pigment epithelium are generally associated with senile macular degeneration, central serous chorioretinopathy, diffuse pigment epitheliopathy, or are idiopathic. The patients studied were divided into two groups: 45 patients under 55 years old (64 eyes), kept under observation for an average of 70 months, and 42 patients over 55 years old kept under observation for an average of 38 months. These two groups were compared with a group of cases of isolated colloidal degeneration. The good prognosis for the first group is emphasized. Stabilization or improvement of visual acuity was normal. In the second group, complications included subretinal neovascularization in 29% and tears in the retinal pigment epithelium in 3.5% of the cases. Visual acuity deteriorated in one-third of the cases. Factors which adversely affected prognosis were an initial detachment larger than the diameter of the optic disk, macular location, and contralateral neovascularization. However, the results with spontaneous evolution were not worse than those in laser-treated cases reported in the literature.