Maurice F. Rabb » Recurrent Central Serous Retinopathy With Edema

This 62 year old male has noted decreased vision recently in the right eye beginning January 1993. His visual symptoms began in the 1970's, with a diagnosis of bilateral central serous retinopathy. There was no treatment.

He saw a second ophthalmologist on 6/5/84, who found that the visual acuity with correciton was OD 20/60-3 and OS 20/100-1. A diagnosis of recurrent central serous retinopathy in both eyes with edema in the right macula was made. Color photographs and fluorescein angiograms were obtained. The color photographs demonstrate multiple scars at the level of the pigment epithelium and the posterior pole of both eyes without evidence of hemorrhage or exudate. The fluorescein angiogram also reveals extensive pigment epithelium abnormalities in the posterior pole bilaterally, with a possible mild fluorescein leakage under the peripapillary retina temporal to the optic disc in the right eye.

This patient next saw a third ophthalmologist on 2/24/92 at which time the visual acuity with correction was OD 20/80- and OS 20/100-. Intraocular pressure was OD 28 and OS 25 iwth normal optic discs. The potential acuity meter test showed vision was OD 20/50 and OS 20/100. Bilateral retinal pigment epithelium scarring in the macula was again noted.

This case is interesting, in that there is remarkable good visual acuity in the left eye despite extensive angiographic changes in the foveal pigment epithelium in the left eye. In the right eye, there has been a 10 month history of decreased vision associated with a persistent shallow serous detachment of the sensory retina in the central and superior macula.