4. Idiopathic disorder (unknown cause)
Localized serous detachment of the neurosensory
retina in the region of macula.
5. Usually occur in male age 25-50 years
In female typically occur at a slightly older age and has
association with pregnancy.
Excessive use of steroids……..
Psych0logical or physiological stress in rare case.
People engaged in visually demanding work.
8. A round or oval detachment of the sensory retina is
present at the macula
The subretinal fluid may be clear (particularly in early
lesions)
One or more abnormal depigmented RPE foci
(sometimes small PED) of variable size may be visible
within the neurosensory detachment.
The optic disc should be examined to exclude a
congenital pit.
9. Amsler gird Amsler grid test to document the area of
field involved. See Appendix 4, Amsler Grid.
Slit-lamp examination of the macula with a fundus
contact, Hruby, or 60- or 90-diopter lens to rule out a
concomitant CNV. In addition, search for an optic pit
of the disc.
Indirect ophthalmoscope dilated fundus examination
with
10. Optical coherence tomography (OCT)
OCT shows an optically empty neurosensory
elevation. A RPE detachment or a deficit in the RPE
may also be seen.
11. Fundus fluorescein angiography
may show the following patterns:
Smoke stack
Manifests as early hyperfluorescein spot. that
progresses to form a vertical column by the late venous
phase.
12. ‘Ink blot’ (most common) shows an early
hyperfluorescein spot. that gradually enlarges .
13. Chronic CSCR
Course lasting more than 12 months constitutes a
minority and typically affects older patients.
• Multiple recurrent attacks may also give a similar
clinical picture.
• FA shows granular hyperfluoresceince with one or
more leaks.
14. Observation:
Prognosis for spontaneous recovery of visual
acuity to at least 20/30 is excellent. Worse prognosis for
patients with recurrent disease, multiple areas of
detachment, or prolonged course.
Laser therapy:
Accelerates visual recovery. Does not improve
final visual outcome. May increase risk of CNV
formation. Given the CNV risk, use low laser intensity.
Consider laser
15. Laser therapy:
Persistence of a serous detachment for several months.
Recurrence of the condition in an eye that sustained a
permanent visual deficit from a previous episode.
Occurrence in the contralateral eye after a permanent
visual deficit resulted from a previous episode.
Patient requires prompt restoration of vision (e.g.,
occupational necessity).
16. Stop steroids:
If possible, including topical skin preparations
and nasal sprays.
anti-VEGF therapy:
If CNV develops.
photodynamic therapy: (PDT)
In case of chronic cscr.