Long-term follow-up of an ophthalmologist's central serous retinopathy, photocoagulated by sungazing.

The author describes his own unilateral multifocal and recurrent central serous retinopathy (CRS). After 71 recurrences during the first 19 years, he photocoagulated the diseased macula three times by sungazing. There were no more recurrences after photocoagulation treatment during the last 10 years. Fluorescence angiography was performed 10 days before and 14 days after the first photocoagulation. At the time of the postoperative angiography, vision was restored from 0.5 to 1.2. The angiogram shows a hyperfluoresence of the "inkblot" type in the centre of the clinical macula, giving evidence that sungazing had produced a focal lesion of the retinal pigment epithelium. The absorption of a macular edema after creation of a "leak" by sungazing can be explained by the hypothesis (Marmor) that most "leaks" do not cause subretinal fluid but represent diffusion of fluorescein down a concentration gradient into the subretinal fluid. In addition to the treatment with solar photocoagulation, vitamin E was taken during the last 11 years. At present, 32 years after the onset of the disease, there is an extensive depigmentation of the macula. Visual acuity is 1.0.