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Case 7-2. Central Serous Chorioretinopathy

Clinical Summary

A 65-year-old man noted decreasing vision in his right eye over the period of one month, On examination, his visual acuity in this eye was 20/50. Dilated ophthalmoscopy (A) showed a serous elevation of the neurosensory retina directly in the macula. A small hyper-fluorescent spot with late leakage superior to the fovea was seen on the fluorescein angiogram (B). Mottled hyperfluo-rescence was also noted further superiorly and superotem-porally in the angiogram.

Optical Coherence Tomography

A vertical OCT tomogram (C) was obtained slightly nasal to the fovea through both the neurosensory detachment and the leakage point located superior to the fovea displayed on angiography The tomogram showed a small serous retina] detachment, with a height of 110 jam at its maximum in the image. The neurosensory retina above the detachment appeared thickened, measuring approximately 300 |im compared with 200 ¬°am at the inferior edge of the image. The optical reflectivity from within the neurosensory retina in this region was reduced, consistent with intraretinal edema and cystic changes. A focal elevation of the reflective band corresponding to the retinal pigment epithelium was noted just superior to the neurosensory detachment on the OCT image, consistent with a small serous detachment of the pigment epithelium (arrow).

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