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ABSTRACT We report the case of a 39-year-old male patient who presented with visual loss in the right eye for 6 weeks. The best-corrected visual acuity was counting fingers in the right eye and 20/30 in the left eye. The fundus examination demonstrated a right retinal detachment inferiorly extending to the fovea and a left macular serous detachment. After multimodal imaging study, the patient was diagnosed as having a bullous variant of central serous chorioretinopathy and treated with oral spironolactone associated with adjuvant laser photocoagulation. The retinal changes resolved after 6 months. The final visual acuity was 20/20 in both eyes.
RESUMO Relatamos o caso de um homem de 39 anos apresentando perda visual no olho direito há seis semanas. A melhor acuidade visual corrigida foi conta-dedos no olho direito e 20/30 no esquerdo. A fundoscopia demonstrou descolamento de retina direito inferiormente com extensão à fóvea e descolamento macular seroso à esquerda. Após estudos de imagem multimodal, o paciente foi diagnosticado com uma variante bolhosa de coriorretinopatia serosa central e tratado com espironolactona oral associada à fotocoagulação a laser adjuvante. As alterações retinianas resolveram após seis meses. A acuidade visual final foi 20/20 em ambos os olhos.
RESUMO
AIM:To investigate the effect of intravitreal ranibizumab ( IVR) in the treatment of exudative age-related macular degeneration ( AMD ) with serous retinal pigment epithelium detachment ( SPED) in elderly patients. ·METHODS: We Selected 60 elderly patients ( 60 eyes ) with AMD and SPED in our hospital from February 2015 to February 2016, treated by intravitreal injection of ranibizumab. The best corrected visual acuity ( BCVA ) , PED height and volume, central fovea thickness ( CFT ) and aqueous humor vascular endothelial growth factor ( VEGF) were measured before and after treatment. ·RESULTS:The BCVA of patients with after treatment for 1, 3 and 6mo were 0. 6 ± 0. 1, 0. 4 ± 0. 1 and 0. 3 ± 0. 1, and were significantly higher than those before treatment ( P<0. 05). At 1, 3 and 6mo after treatment PED height and volume were significantly lower than before treatment (P<0. 05), of which 6mo after the treatment PED height and volume were 240. 02 ± 35. 10μm and 0. 310 ± 0. 120mm3 . At 6mo after treatment CFT was 290. 02±33. 10μm, significantly lower than before and 1mo after treatment (P<0. 05). At 1, 3 and 6mo after treatment VEGF were lower than those before treatment (P<0. 05), in which 6mo after the treatment aqueous humor VEGF was 149. 11 ± 28. 89pg/mL. No endophthalmitis, uveitis and so on adverse reactions were observed during treatment. ·CONCLUSION:IVR has a good effect in the treatment of exudative AMD in elderly patients with serous PED, which can effectively improve the visual acuity of patients, reduce the height and volume of PED and the concentration of VEGF in aqueous humor, and it is safe and reliable.
RESUMO
The cause of central serous chorioretinopathy (CSC) is mostly idiopathic. Other cause such as stressful event or use of corticosteroid has been associated with severe form of CSC. Atypical presentation of CSC has widespread degeneration of retinal pigment epithelium (RPE) or bullous retinal detachment. In this report, we describe a case of bilateral CSC with RPE tear after epidural steroid injection.