𝘈𝘤𝘶𝘵𝘦 𝘊𝘦𝘯𝘵𝘳𝘢𝘭 𝘚𝘦𝘳𝘰𝘶𝘴 𝘊𝘩𝘰𝘳𝘪𝘰𝘳𝘦𝘵𝘪𝘯𝘰𝘱𝘢𝘵𝘩𝘺 𝘗𝘢𝘳𝘵 𝟷- 𝘍𝘶𝘯𝘥𝘶𝘴 𝘢𝘯𝘥 𝘖𝘊𝘛 𝘧𝘪𝘯𝘥𝘪𝘯𝘨𝘴
● Serous detachment of the neurosensory retina in the macular area
● Male patients, 20-55 years
𝘙𝘪𝘴𝘬 𝘧𝘢𝘤𝘵𝘰𝘳𝘴:
● Type A personality
● Stress
● Hypertension
● Smoking
● Autoimmune disorders
● Organ transplantation patients
● Pregnancy
● Medications such as steroids, sildenafil
𝘗𝘢𝘵𝘩𝘰𝘨𝘦𝘯𝘦𝘴𝘪𝘴:
1. Focal and multifocal areas of leakage secondary to choroidal hyperpermeability
2. Abnormal ion transport across the RPE- Barrier defect
Localised capillary/venous congestion leads to impairment of circulation causing ischemia → increased choroidal exudation, hyperpermeable choroid leading to excess choroidal fluid accumulation causing retinal pigment epithelial detachment→ As detachment increases target junctions between RPE are broken, focal defect of BRB develops → Choroidal fluid passes through thereby causing neurosensory detachment
𝘚𝘪𝘨𝘯𝘴 𝘢𝘯𝘥 𝘚𝘺𝘮𝘱𝘵𝘰𝘮𝘴:
● Unilateral blurred vision which can be corrected with a hyperopic correction
● Relative scotoma in the central visual field
● Metamorphopsia, micropsia
● Colour desaturation, impaired dark adaptation
𝘍𝘶𝘯𝘥𝘶𝘴 𝘧𝘪𝘯𝘥𝘪𝘯𝘨𝘴:
● Round, well delineated shallow serous neurosensory detachment at the macula surrounded by a halo light reflex and absence of foveal reflex (top left photo)
● Subretinal precipitates (fibrin) (top right photo)
● Pigment epithelial detachments (PED) maybe present
𝘖𝘱𝘵𝘪𝘤𝘢𝘭 𝘊𝘰𝘩𝘦𝘳𝘦𝘯𝘤𝘦 𝘛𝘰𝘮𝘰𝘨𝘳𝘢𝘱𝘩𝘺 𝘧𝘪𝘯𝘥𝘪𝘯𝘨𝘴 𝘰𝘧 𝘈𝘤𝘶𝘵𝘦 𝘊𝘚𝘊𝘙:
1. Neurosensory retinal detachment with subretinal fluid (bottom photo)
2. Pigment epithelial detachment
3. Fibrinous exudates in subretinal space
4. Shaggy outer segments of NSR above leakage site
FFA findings of Acute CSCR and Treatment - Continued in Part 2
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