|Year : 1979 | Volume
| Issue : 4 | Page : 178-179
Central serous retinopathy
Retina Foundation, Aso-Palov Eye Hosp. Ahemdabad, India
P N Nagpal
Retina Foundation, Aso-Palov Eye Hosp. Near Under Bridge, Rajbhavan Road, Shahibag, Ahemdabad
|How to cite this article:|
Nagpal P N. Central serous retinopathy. Indian J Ophthalmol 1979;27:178-9
The findings of fluorescein angiography in central serous retinopathy are of great importance for therapy. It is the purpose of this paper to demonstrate the value of photocoagulation in this field and present our own experience and results.
It was Maumenee and Norton et al who demonstrated a localised leakage of fluorescein in late phase of fluorescein angiography. It was the idea of Maumenee that fluorescein leakages are defects in Bruch's membrane and in the pigment epithelium allowing leakage from chorio-capillaries into the sub-retinal space. The leakage point should be occluded by photocoagulation.
| Materials and Methods|| |
Out of 23 cases of central serous retinopathy and allied disorders, 16 cases were subjected to fluorescein photography using Kowa R C II fundus camera. In the remaining cases the photography was not possible due to various reasons. Angioscopy was carried out and the findings charted out for records. 5 cc of 10% fluorescein sodium solution was used.
Clinitex Log-2 Xenon photocoagulator was used for coagulation of leakage points. A minimal reaction was created for creating the scar over the leakage points.
Observations and Comments
Of the 23 cases of central serous retinopathy in 20 cases I found leakage points and in 2 cases there was a total staining of the detached area. In a single case no staining was detected. Sometime the leakage point was situated very close to fovea centralis and at other times was even away from it. [Figure - 1]. In 2 of our cases there were more than one areas of detachment [Figure - 2].
13 cases were subjected to photocoagulation. All the cases were also put on anti Kochs+steroids therapy with the idea to prevent recurrences of formations of lleakage points. The long term follow up will show the incidence of recurrences but one thing is certain that detachment vanished in all cases subjected to photocoagulation within 8-10 days. Those cases which were not photocoagulated it took longer time for detachment to settle and hence left behind a greater degenerative damage to retina.
Wessing has found regression of oedema and reduction of hypermetropia in cases where photocoagulation was done on the margin of oedematous area because of the difficulty of coagulating the leakage point which was very close to fovea centralis. He assigned the improvement to a possible closure of leakage points by the sero fibrinous exudate created by the photocoagulation reaction. It is the balance of amount of fluid leakage through the point into subretinal space and the amount absorbed from the surface of the pigment layer and choroid that possibly explains the restriction of the size of the central serous detachment and its confinement to central fundus, Whatever the etiology, photocoagulation seems to provide an immediate cure of the central macular detachment.
| Summary|| |
Fluorescein angiography was carried out in 23 cases of central serous retinopathy and allied disorders. Uniformly good results were obtained by photocoagulating the leaking spots in 13 cases.
| References|| |
|1.||Maumenee, A.E., 1965, Trans. Amer. Acad. Ophthal., 69, 615. |
|2.||Norton, Gas Smith et al, 1965, Trans. Amer. Acad. Ophthal., 69, 631. |
|3.||Wessing, A., 1971, Photography in Ophthalmica Int. Symp. Fluoriscine Angiography Miami 1970, Mod. Probl. Ophthal,, 9, 148, 1971. |
[Figure - 1], [Figure - 2]