Department of Vitreo-Retinal Disease, LV Prasad Eye Institute, Hyderabad, India.
Department of Vitreo-Retinal Disease, LV Prasad Eye Institute, Hyderabad, India
BMJ Case Rep. 2020 Sep 23;13(9):e235882. doi: 10.1136/bcr-2020-235882.
A 68-year-old man presented with diminution of distance and near vision in the right eye for a duration of 1 month postblunt trauma with a stick. On examination, his visual acuity in the right eye was 20/320 and near vision was <N36. Right eye fundus showed bullous neurosensory retinal detachment at posterior pole and retinal pigment epithelium (RPE) atrophic area temporal to fovea. Optical coherence tomography showed subretinal fluid with pigment epithelial detachment and an area of RPE and photoreceptor loss temporal to fovea. Fundus fluorescein angiography and indocyanine green angiography showed focal leaks and transmitted hyperfluorescence corresponding to the area of RPE loss. Left eye examination was unremarkable except for senile cataract of nuclear opalescence grade 3. A diagnosis of right eye bullous central serous chorioretinopathy (CSCR) and RPE sequelae postblunt trauma was made. Our patient was managed conservatively with no specific treatment for CSCR. One month later, there was improvement in vision with decrease in neurosensory detachment. The area of RPE loss remained the same with photoreceptor loss. Since this area of RPE and photoreceptor loss were temporal to fovea, our patient's visual acuity was not affected significantly.
一位 68 岁男性,1 个月前因钝器伤右眼被棍棒击伤后出现远、近视力下降。检查发现右眼视力 20/320,近视力<N36。右眼眼底后极部可见泡状神经感觉性视网膜脱离和视网膜色素上皮(RPE)萎缩区位于黄斑颞侧。光学相干断层扫描显示视网膜下积液伴色素上皮脱离和黄斑颞侧RPE 和光感受器缺失区。眼底荧光素血管造影和吲哚青绿血管造影显示相应 RPE 缺失区存在局灶性渗漏和荧光素传递增强。左眼检查除核性白内障 3 级外无明显异常。右眼诊断为泡状中心性浆液性脉络膜视网膜病变(CSCR)和钝器伤后 RPE 后遗症。患者接受保守治疗,未针对 CSCR 进行特殊治疗。1 个月后,神经感觉性脱离减少,视力有所改善。RPE 缺失区和光感受器缺失区保持不变。由于这部分 RPE 和光感受器缺失位于黄斑颞侧,患者的视力未受到明显影响。