Fluid in the fovea
๐๐ค๐ถ๐ต๐ฆ ๐๐ฆ๐ฏ๐ต๐ณ๐ข๐ญ ๐๐ฆ๐ณ๐ฐ๐ถ๐ด ๐๐ฉ๐ฐ๐ณ๐ช๐ฐ๐ณ๐ฆ๐ต๐ช๐ฏ๐ฐ๐ฑ๐ข๐ต๐ฉ๐บ ๐๐ข๐ณ๐ต ๐ท- ๐๐ถ๐ฏ๐ฅ๐ถ๐ด ๐ข๐ฏ๐ฅ ๐๐๐ ๐ง๐ช๐ฏ๐ฅ๐ช๐ฏ๐จ๐ดโฃ
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โ Serous detachment of the neurosensory retina in the macular areaโฃ
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โ Male patients, 20-55 yearsโฃ
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๐๐ช๐ด๐ฌ ๐ง๐ข๐ค๐ต๐ฐ๐ณ๐ด:โฃ
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โ Type A personalityโฃ
โ Stressโฃ
โ Hypertensionโฃ
โ Smokingโฃ
โ Autoimmune disordersโฃ
โ Organ transplantation patientsโฃ
โ Pregnancyโฃ
โ Medications such as steroids, sildenafilโฃ
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๐๐ข๐ต๐ฉ๐ฐ๐จ๐ฆ๐ฏ๐ฆ๐ด๐ช๐ด:โฃ
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1. Focal and multifocal areas of leakage secondary to choroidal hyperpermeabilityโฃ
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2. Abnormal ion transport across the RPE- Barrier defectโฃ
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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 detachmentโฃ
๐๐ช๐จ๐ฏ๐ด ๐ข๐ฏ๐ฅ ๐๐บ๐ฎ๐ฑ๐ต๐ฐ๐ฎ๐ด:โฃ
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โ Unilateral blurred vision which can be corrected with a hyperopic correctionโฃ
โ Relative scotoma in the central visual fieldโฃ
โ Metamorphopsia, micropsiaโฃ
โ Colour desaturation, impaired dark adaptationโฃ
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๐๐ถ๐ฏ๐ฅ๐ถ๐ด ๐ง๐ช๐ฏ๐ฅ๐ช๐ฏ๐จ๐ด:โฃ
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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)โฃ
โ Subretinal precipitates (fibrin) (top right photo)โฃ
โ Pigment epithelial detachments (PED) maybe presentโฃ
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๐๐ฑ๐ต๐ช๐ค๐ข๐ญ ๐๐ฐ๐ฉ๐ฆ๐ณ๐ฆ๐ฏ๐ค๐ฆ ๐๐ฐ๐ฎ๐ฐ๐จ๐ณ๐ข๐ฑ๐ฉ๐บ ๐ง๐ช๐ฏ๐ฅ๐ช๐ฏ๐จ๐ด ๐ฐ๐ง ๐๐ค๐ถ๐ต๐ฆ ๐๐๐๐:โฃ
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1. Neurosensory retinal detachment with subretinal fluid (bottom photo)โฃ
2. Pigment epithelial detachmentโฃ
3. Fibrinous exudates in subretinal spaceโฃ
4. Shaggy outer segments of NSR above leakage siteโฃ
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FFA findings of Acute CSCR and Treatment - Continued in Part 2โฃ
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www.ophthalmobytes.comโฃ
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Image from Rajan Eye Care Hospital
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