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Fluid in the fovea!

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⁣




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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