Case Reports in Ophthalmology (May 2022)

A Case of Bullous Central Serous Chorioretinopathy Treated with Surgical Removal of Submacular Fibrin and Subsequent Photodynamic Therapy under Silicone Oil

  • Shoji Notomi,
  • Satomi Shiose,
  • Ri-ichiro Kohno,
  • Sakurako Shimokawa,
  • Keijiro Ishikawa,
  • Kumiko Kano,
  • Kenichiro Mori,
  • Iori Wada,
  • Yosuke Fukuda,
  • Shunji Nakatake,
  • Muneo Yamaguchi,
  • Koh-Hei Sonoda

DOI
https://doi.org/10.1159/000524515
Journal volume & issue
Vol. 13, no. 2
pp. 385 – 392

Abstract

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Bullous retinal detachment is a rare complication in the chronic phase of central serous chorioretinopathy (CSC). Only a small subset of eyes with chronic CSC develops into the bullous variant of CSC (bCSC). In patients with bCSC, the elevated concentration of fibrin in the subretinal space leads to persistent retinal detachment and eventually, severe vision loss. We experienced a case of unilateral bCSC with a massive accumulation of subretinal fibrin. Multiple leakage points and dilated choroidal veins were also observed. The patient underwent surgical removal of subretinal fibrin and silicone oil injection followed by photodynamic therapy (PDT). After this treatment, the retina was successfully reattached, and the affected eye was free from recurrent exudative changes for more than 18 months. Massive subretinal fibrin could be surgically removed to prevent the formation of subretinal fibrosis and retinal fold, and PDT under silicone oil can control the underlying exudative changes in bCSC.

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