๐๐๐ ๐ง๐ช๐ฏ๐ฅ๐ช๐ฏ๐จ๐ด ๐ฐ๐ง ๐๐ค๐ถ๐ต๐ฆ ๐๐๐๐โฃ โฃ ๐๐ง๐ค ๐๐ฅ๐จ๐ญ/ ๐๐ฑ๐ฉ๐๐ง๐ฌ๐ข๐ฅ๐ ๐๐จ๐ญโฃ โฃ โ 90%โฃ โ Small, focal hyperfluorescence leak from choroid through RPEโฃ โ Early phase of FFAโฃ โ Increases in size and intensityโฃ โ Multiple leakage spots can be presentโฃ โฃ ๐๐ฆ๐จ๐ค๐๐ฌ๐ญ๐๐๐คโฃ โฃ โ 10%โฃ โ Central spot of hyperfluorescenceโฃ โ Spreads vertically and laterally in a configuration of a plume of smoke/ mushroomโฃ cloud/ umbrella in the late phaseโฃ โ Due to convection currents and a pressure gradient between increased proteinโฃ concentration of subretinal fluid and fluorescein dye entering the detachmentโฃ
โฃ ๐๐ข๐๐๐ฎ๐ฌ๐ ๐ฉ๐๐ญ๐ญ๐๐ซ๐งโฃ โฃ โ Rareโฃ โ No obvious leakage pointsโฃ โฃ ๐๐๐ ๐ง๐ช๐ฏ๐ฅ๐ช๐ฏ๐จ๐ด ๐ฐ๐ง ๐๐ค๐ถ๐ต๐ฆ ๐๐๐๐โฃ โฃ โ Delay in choroidal filling in early phase with hypofluorescent areas due to non perfusion of choriocapillariesโฃ โ Choroidal venous dilatation and choroidal hyperpermeability -- zone of hyperfluorescence in mid phaseโฃ โ Washout/ persistent hyperfluorescence in late phaseโฃ โฃ ๐๐ณ๐ฆ๐ข๐ต๐ฎ๐ฆ๐ฏ๐ต ๐๐ฏ๐ฅ๐ช๐ค๐ข๐ต๐ช๐ฐ๐ฏ๐ด:โฃ โฃ โ Persistent serous retinal detachment >3-4 monthsโฃ โ Recurrence in an eye with visual defects from previous CSCRโฃ โ Opposite eye with visual defects due to CSCRโฃ โ Bilateral CSCR for early rehabilitationโฃ โ Occupational needโฃ โ Recurrent CSCR with leak located more than than 300 microns from centre of foveaโฃ โ Development of chronic signsโฃ โฃ ๐๐ฑ๐ต๐ช๐ฐ๐ฏ๐ด:โฃ โ Laser photocoagulationโฃ โ Photodynamic therapyโฃ โ Medical management: Oral eplerenoneโฃ โ Anti VEGF therapy in case CNV developsโฃ โฃ www.ophthalmobytes.comโฃ โฃ 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 #centralserouschorioretinopathy #cscr#cscr #neurosensorydetachment#neurosensorydetachment #inkblot#inkblot #smokestack#smokestack