Chronic central serous chorioretinopathy associated with serous retinal detachment in a series of Asian patients.
OBJECTIVE
To determine clinical features of patients with severe chronic central serous chorioretinopathy (diffuse retinal pigment epitheliopathy, DRPE) associated with bullous retinal detachment in Thailand.


METHODS
The authors reviewed clinical and imaging characteristics, visual outcomes, and complications of 7 patients with severe DRPE associated with bullous retinal detachment.


RESULTS
Included were 6 males and 1 female with average age at onset of 39 years (range 30-46 years) diagnosed with DRPE. Although 4 patients had unilateral complaints, retinal pigment epithelium (RPE) changes on fluorescein angiography (FA) were visible in both eyes in all patients and 10 out of 14 affected eyes exhibited large exudative bullous retinal detachments (RD) and evidence of multiple characteristic leakage points. The disease was induced by steroid medications in 3 patients and an additional 3 patients received steroid treatment after they were initially considered to have Harada disease. The administration of steroids caused worsening in all cases.


CONCLUSIONS
Chronic central serous chorioretinopathy associated with bullous retinal detachment is a severe variant of DRPE, which might be mistaken for Harada disease. The early diagnosis of DRPE might prevent the complications from harmful medications as well as unnecessary surgery and visual loss.
Kunavisarut
Paradee
P
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. pkunavis@mail.med.cmu.ac.th
Pathanapitoon
Kessara
K
van Schooneveld
Mary
M
Rothova
Aniki
A
D000328:Adult; D044466:Asian People; D015862:Choroid Diseases / Q000139:chemically induced / Q000150:complications* / Q000208:ethnology; D002908:Chronic Disease; D003937:Diagnosis, Differential; D018450:Disease Progression; D005122:Exudates and Transudates / Q000378:metabolism; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012163:Retinal Detachment / Q000139:chemically induced / Q000150:complications* / Q000208:ethnology / Q000378:metabolism; D012164:Retinal Diseases / Q000139:chemically induced / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D055213:Retinal Pigment Epithelium / Q000187:drug effects; D013256:Steroids / Q000009:adverse effects; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis; D014792:Visual Acuity
D013256:Steroids