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Clinical Summary

A 41-vear-old man had both a neurosensory detach-

/ j ment and a retinal pigment epithelial detachment of the macula of his right eye which was associated with the diagnosis of idiopathic central serous chorioretinopathy (A). His visual acuity was 20/40. Fluorescein angiography (B) displayed filling of a small retinal pigment epithelial detachment temporal to the fovea and hyperfluorescence along the superotemporal arcade in the temporal macula consistent with a neurosensory detachment of the retina.

Optical Coherence Tomography

OCT images were obtained through both areas of retinal pathology A tomogram (C; white line on A) taken through the area of retinal pigment epithelium (RPE) detachment toward the optic disc showed elevation of both the retina and RPE over an optically clear space consistent with serous fluid. The choroidal tissue beneath the detachment was shadowed by the highly backscattering RPE above. The adjacent normal retina in the image showed that the reflective band corresponding to the RPE and cho-riocapillaris was thicker than the detached RPE alone. An OCT image (E; black line on A) taken through the area of the neurosensory detachment revealed an elevation of the neurosensory retina and a large area of low reflectivity consistent with a flu id-filled space. The reflective band corresponding to RPE and choriocapillaris in this image appeared intact beneath the serous fluid cavity, except where it was shadowed bv retinal blood vessels.

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