Bullous retinal detachment in a patient with central serous chorioretinopathy. 1998

C M Yang, and C P Lin
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Bullous retinal detachment, a severe and atypical presentation of central serous chorioretinopathy (CSCR), may develop in association with the use of systemic steroids. A 42-year-old man presented with a 2-month history of poor visual acuity in his right eye. A tentative diagnosis of Harada's syndrome was made and the patient was treated with large doses of systemic corticosteroids for 1 month, without improvement. Fundus examination showed bullous detachment with shifting subretinal fluid in both eyes. Fluorescein angiography demonstrated multiple leaking points with pigment epithelium detachment in both eyes. A diagnosis of bilateral severe CSCR was made and systemic steroid therapy was withdrawn. Several sessions of argon laser photocoagulation to the areas of fluorescein leakage in both eyes and transscleral drainage of subretinal fluid in the right eye were performed. Two months later, the retinae became attached in both eyes. Visual acuity in the right eye was limited by submacular fibrosis, while the visual acuity of the left eye was not affected. In summary, this case should alert physicians to suspect CSCR in patients with exudative retinal detachment, as the use of steroids is usually not only unnecessary but can also be harmful.

UI MeSH Term Description Entries
D008297 Male Males
D011239 Prednisolone A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. Di-Adreson-F,Predate,Predonine,Di Adreson F,DiAdresonF
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D012164 Retinal Diseases Diseases involving the RETINA. Disease, Retinal,Diseases, Retinal,Retinal Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015862 Choroid Diseases Disorders of the choroid including hereditary choroidal diseases, neoplasms, and other abnormalities of the vascular layer of the uvea. Choroidal Diseases,Choroid Disease,Choroidal Disease,Disease, Choroid,Disease, Choroidal,Diseases, Choroid,Diseases, Choroidal

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