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Fluid in the fovea!

๐˜ˆ๐˜ค๐˜ถ๐˜ต๐˜ฆ ๐˜Š๐˜ฆ๐˜ฏ๐˜ต๐˜ณ๐˜ข๐˜ญ ๐˜š๐˜ฆ๐˜ณ๐˜ฐ๐˜ถ๐˜ด ๐˜Š๐˜ฉ๐˜ฐ๐˜ณ๐˜ช๐˜ฐ๐˜ณ๐˜ฆ๐˜ต๐˜ช๐˜ฏ๐˜ฐ๐˜ฑ๐˜ข๐˜ต๐˜ฉ๐˜บ ๐˜—๐˜ข๐˜ณ๐˜ต ๐Ÿท- ๐˜๐˜ถ๐˜ฏ๐˜ฅ๐˜ถ๐˜ด ๐˜ข๐˜ฏ๐˜ฅ ๐˜–๐˜Š๐˜› ๐˜ง๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ฏ๐˜จ๐˜ดโฃ

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โ— Serous detachment of the neurosensory retina in the macular areaโฃ

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โ— Male patients, 20-55 yearsโฃ

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๐˜™๐˜ช๐˜ด๐˜ฌ ๐˜ง๐˜ข๐˜ค๐˜ต๐˜ฐ๐˜ณ๐˜ด:โฃ

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โ— Type A personalityโฃ

โ— Stressโฃ

โ— Hypertensionโฃ

โ— Smokingโฃ

โ— Autoimmune disordersโฃ

โ— Organ transplantation patientsโฃ

โ— Pregnancyโฃ

โ— Medications such as steroids, sildenafilโฃ

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๐˜—๐˜ข๐˜ต๐˜ฉ๐˜ฐ๐˜จ๐˜ฆ๐˜ฏ๐˜ฆ๐˜ด๐˜ช๐˜ด:โฃ

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1. Focal and multifocal areas of leakage secondary to choroidal hyperpermeabilityโฃ

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2. Abnormal ion transport across the RPE- Barrier defectโฃ

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Localised capillary/venous congestion leads to impairment of circulation causing ischemia โ†’ increased choroidal exudation, hyperpermeable choroid leading to excess choroidal fluid accumulation causing retinal pigment epithelial detachmentโ†’ As detachment increases target junctions between RPE are broken, focal defect of BRB develops โ†’ Choroidal fluid passes through thereby causing neurosensory detachmentโฃ




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๐˜š๐˜ช๐˜จ๐˜ฏ๐˜ด ๐˜ข๐˜ฏ๐˜ฅ ๐˜š๐˜บ๐˜ฎ๐˜ฑ๐˜ต๐˜ฐ๐˜ฎ๐˜ด:โฃ

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โ— Unilateral blurred vision which can be corrected with a hyperopic correctionโฃ

โ— Relative scotoma in the central visual fieldโฃ

โ— Metamorphopsia, micropsiaโฃ

โ— Colour desaturation, impaired dark adaptationโฃ

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๐˜๐˜ถ๐˜ฏ๐˜ฅ๐˜ถ๐˜ด ๐˜ง๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ฏ๐˜จ๐˜ด:โฃ

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โ— Round, well delineated shallow serous neurosensory detachment at the macula surrounded by a halo light reflex and absence of foveal reflex (top left photo)โฃ

โ— Subretinal precipitates (fibrin) (top right photo)โฃ

โ— Pigment epithelial detachments (PED) maybe presentโฃ

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๐˜–๐˜ฑ๐˜ต๐˜ช๐˜ค๐˜ข๐˜ญ ๐˜Š๐˜ฐ๐˜ฉ๐˜ฆ๐˜ณ๐˜ฆ๐˜ฏ๐˜ค๐˜ฆ ๐˜›๐˜ฐ๐˜ฎ๐˜ฐ๐˜จ๐˜ณ๐˜ข๐˜ฑ๐˜ฉ๐˜บ ๐˜ง๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ฏ๐˜จ๐˜ด ๐˜ฐ๐˜ง ๐˜ˆ๐˜ค๐˜ถ๐˜ต๐˜ฆ ๐˜Š๐˜š๐˜Š๐˜™:โฃ

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1. Neurosensory retinal detachment with subretinal fluid (bottom photo)โฃ

2. Pigment epithelial detachmentโฃ

3. Fibrinous exudates in subretinal spaceโฃ

4. Shaggy outer segments of NSR above leakage siteโฃ

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FFA findings of Acute CSCR and Treatment - Continued in Part 2โฃ

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www.ophthalmobytes.comโฃ

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Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #retina #macula #cscr #subretinalfluid

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