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Agustina C Palacio, Sebastian Inchauspe, emilio dodds; Characterization of central serous chorioretinopathy associated with subretinal fibrin.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4250.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the demographic characteristics and clinical features of central serous chorioretinopathy (CSC) associated with subretinal fibrin
Retrospective, observational case series consisting of 19 eyes of 10 patients with CSC associated with subretinal fibrin and bullous retinal detachment. Patient charts were reviewed including color fundus photos and fluorescein angiography. Information about patient age at diagnosis, systemic comorbidities, corticosteroid use, ophthalmic exam including visual acuity, and clinical course was collected.
Eight patients were male (80%), and 2 were female (20%). Mean age at diagnosis was 40.7 +/- 7.7 years. Five patients were lost to follow up. The mean follow-up period of the remaining 5 patients was 56.29 +/- 57.8 months. Mean BCVA was 0.16 +/- 0.2 at presentation and 0.34 +/- 0.39 at the final visit. All eyes presented with multiple foci of subretinal fibrin and bullous retinal detachment with shifting fluid. Dark spots within the fibrin foci were present in 8 eyes (42%) and perivascular deposits in 9 eyes (47%). The presentation was bilateral in 9 patients (90%). Nine eyes (47%) demonstrated an expansile dot pattern in the initial FA.Comorbidities included systemic lupus erythematosus, renal insufficiency, and non-ocular tuberculosis. The other 4 patients (40%) were healthy. The disease was associated with the use of corticosteroids in 8 patients (80%). All 5 patients who had received corticosteroids and had sufficient follow-up showed improvement upon their cessation. One patient had a recurrence after re-administration of corticosteroids.Eight patients (80%) were referred with a different diagnosis, the most common of which was multifocal choroiditis. Exudate biopsy was performed on one patient and demonstrated fibrinous exudate containing crystalline structures
Subretinal fibrin with bullous retinal detachment is a rare manifestation of CSC that is frequently associated with corticosteroid use. Diagnosis of the disease can be challenging and the prognosis is poor. To our knowledge this is the first time a biopsy of the subretinal fibrin was performed.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Color fundus photograph demonstrating subretinal fibrin and associated bullous retinal detachment
Fluorescein angiography demonstrating an expansile dot pattern with diffuse changes to the retinal pigment epithelium.
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