Título

Severe Visual Loss in Central Serous Chorioretinopathy

Objetivo

To report five clinical cases of Central Serous Chorioretinopathy(CSCR) after long -standing macular sensorial retinal detachment that evolved with damage of the outer retina and macular atrophy.

Relato do Caso

This is a retrospective case series of five clinical cases of Central Serous Chorioretinopathy after long –standing macular sensorial retinal macular sensorial retinal detachment. The patients presents a fundoscopic ,Fluorescein Angiography and Optical Coherence Tomography findings of macular sensorial retinal detachment and the diagnostic was Central Serous Chorioretinopathy. One case was the bilateral presentation with nonmacular disease and macular disease too.All patients has been followed for at least 6 months and the diagnosis time was more than one year. The most recent unilateral case was treated witn Spironolactone oral therapy . All patients presented visual acuity with count fingers in the affected eyes with macular sensorial retinal detachment and in the nonmacular case the visual acuity was 20/100 All patients evolved with outer retina damage and macular atrophy with loss of Ellipsoid Zone and External Limiting Membrane. Attenuation of Outer nuclear Layer . The final visual acuity was count fingers in the affected eye in all patients and 20/100 in nonmacular disease case .

Conclusão

This anusual evolution in the Central Serous Chrioretinopathy disease call the attention because the clinical signs were all presents and no doubt has been in the moment of diagnosis that excluded VKH disease and others diseases that cause macular sensorial retinal detachment. Often with resolution of SRF with CSCR can be outer retinal atrophy and photorereceptors loss . This is more typical of chronic cases of CSCR. Presumably macular detachment ,especially if chronic or recalcitrant or recurrent ,can lead to disruption of photoreceptors viability and associated outer retinal atrophy