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IM Donsoff, AP Ciardella, DL L Costa, SJ Huang, N Borodoker, MF Marmor, LA Yannuzzi; Chronic Central Serous Chorioretinopathy Presenting with Peripheral Lipid Exudation . Invest. Ophthalmol. Vis. Sci. 2002;43(13):491.
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Purpose: Dependent exudative detachments may be due to a myriad of chorioretinal disorders including neovascular maculopathies, inflammatory and infiltrative uveal scleral diseases, vasoproliferative abnormalities, and chronic central serous chorioretinopathy. Chronic detachments may also result in a secondary retinal microangiopathy with telangiectasias, non-perfusion, and neovascularization. We describe the appearance of peripheral lipid exudation and modulation of the peripheral microangiopathy following the resolution of a dependent detachment in patients with chronic central serous chorioretinopathy. Method: Retrospective chart review. Results: Four patients with chronic central serous chorioretinopathy and a peripheral dependent detachment with secondary microangiopathy were identified. One patient had history of systemic lupus; one patient had undergone organ transplantation, and one patient was pregnant at the time of diagnosis. Two patients received systemic corticosteroid treatment prior to diagnosis. Following the treatment to posterior retinal pigment epithelium leak and resolution of the detachment, all patients developed lipid precipitation in the peripheral retina. There was also remodeling of the retinal circulation including regression of telangiectasias and neovascularization after the detachment has resolved. Conclusion: Peripheral lipid deposition and remodeling of retinal circulation may develop following the resolution of dependent detachment secondary to chronic central serous chorioretinopathy. It is not necessary to treat the peripheral detachment to restore normal retinal circulation. Eventual regression of the precipitated lipid and associated intraretinal telangiectasias, retinal ischemia, and neovascularization was observed after the resolution of the dependent detachment.
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