Department of Vitreo-Retina, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, India .
Retin Cases Brief Rep. 2022 Nov 1;16(6):735-739. doi: 10.1097/ICB.0000000000001065.
We describe long-term follow-up of a patient with atypical chronic central serous chorioretinopathy with inferior bullous retinal detachment and 360° choroidal detachment, findings on multimodal imaging, differential diagnoses, and treatment.
Case report.
A 66-year-old male patient, known case of bilateral chronic central serous chorioretinopathy on follow-up, presented to us with sudden painless worsening of vision in the right eye. The fundus examination, optical coherence tomography, and fundus fluorescein angiography showed an atypical chronic central serous chorioretinopathy with inferior bullous retinal detachment and peripheral choroidal detachment. The patient underwent half-fluence photodynamic therapy in the right eye. At 3 months post-photodynamic therapy, there was resolution of choroidal detachment and minimal subretinal fluid was persisting in the inferior periphery, with improvement in visual acuity.
Posterior choroidal loculation of fluid is a described entity in central serous chorioretinopathy. The possible explanations for anterior choroidal loculation of fluid in this case are: either a fresh excessive leakage of fluid from the posterior choroid and that fluid may have traversed to the peripheral choroid, or diffuse choroidal leakage extending up to the equatorial region, which resulted in peripheral choroidal thickening and suprachoroidal fluid accumulation.
我们描述了一位患有非典型慢性中心性浆液性脉络膜视网膜病变伴下方疱状视网膜脱离和 360°脉络膜脱离患者的长期随访结果，包括多模态成像表现、鉴别诊断和治疗。
病例报告。
一位 66 岁男性患者，双侧慢性中心性浆液性脉络膜视网膜病变随访患者，因右眼无痛性视力突然恶化就诊。眼底检查、光学相干断层扫描和眼底荧光血管造影显示非典型慢性中心性浆液性脉络膜视网膜病变伴下方疱状视网膜脱离和周边脉络膜脱离。患者右眼行半剂量光动力疗法治疗。光动力治疗后 3 个月，脉络膜脱离得到缓解，下方周边仍有少量视网膜下积液，视力有所改善。
后部脉络膜积液局限性分布是中心性浆液性脉络膜视网膜病变的一种已知表现。在这种情况下，前部脉络膜积液局限性分布的可能解释是：后部脉络膜的液体过度渗漏，可能已经穿过脉络膜进入周边区域，或者是弥漫性脉络膜渗漏延伸到赤道区域，导致周边脉络膜增厚和脉络膜上腔积液。
