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Case Reports
. 2012 May 26:2012:bcr0120125626.
doi: 10.1136/bcr.01.2012.5626.

Central serous chorioretinopathy after blunt trauma

Claudia Maria Prospero Ponce  1 , Hasan M Mohidat, Charles A Garcia
Affiliations
Case Reports

Central serous chorioretinopathy after blunt trauma

Claudia Maria Prospero Ponce et al. BMJ Case Rep. .

Abstract

The authors report a case of a 46-year-old Hispanic male with central serous chorioretinopathy (CSC) following blunt trauma to the left eye. The patient presented with a complaint of throbbing headache and blurry vision in left eye. The patient was diagnosed with diabetes mellitus 1 year previous to the event. On examination, uncorrected visual acuity was 20/20 OD, 20/200 OS. No anisocoria or afferent pupillary defect was present. Intraocular pressure was normal. Subconjunctival haemorrhage and lid ecchymosis were present in OS and fundus examination showed serous macular detachment and central retinal pigment epithelium detachment, and no evidence of diabetic retinopathy. Optical coherence tomography OS showed subretinal fluid and fluorescein angiography demonstrated the typical 'smokestack' pattern of leakage into the subretinal space. The patient received observational therapy for 4 months and the CSC spontaneously resolved with visual acuity of 20/20 in left eye.

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Conflict of interest statement

Competing interests: In the general practice of ophthalmology it is important to be familiar with the causes of visual loss in a patient that undergoes eye trauma. Although CSC is not commonly the cause, the ophthalmologist needs to discard it by performing a thorough examination of the anterior and posterior segments of the eye.

Figures

Figure 1
Figure 1
Fundus photography of the left eye showing neurosensory detachment of most of the macula with retinal pigment epithelium defect superionasal to the fovea (arrow).
Figure 2
Figure 2
Optical coherence tomography of the left eye demonstrating neurosensory detachment of the left macula (arrow).
Figure 3
Figure 3
(A) Arterio-venous phase fluorescein angiography of left eye showing focal leakage superonasal to the fovea. (B) Late phase fluorescein angiography of left eye showing the progressive expansion of hyperfluorescence from the site of leakage (asterix) and pooling of fluorescein in the area of retinal detachment (arrows). This is the classic ‘smokestack’ appearance of central serous chorioretinopathy.
Figure 4
Figure 4
Fluorescein angiography of left eye showing absence of leakage, and the residual window defects in the retinal pigment epithelium layer in the macula, at the 4 months follow-up visit.
Figure 5
Figure 5
Optical coherence tomography of the left eye 4 months after the acute event, showing minimal subretinal fluid (arrow).
See this image and copyright information in PMC

References

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