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 Table of Contents  
CASE REPORT
Year : 2017  |  Volume : 55  |  Issue : 3  |  Page : 231-232

Exudative retinal detachment and retinal pigment epithelial rip due to central serous retinopathy in eye with diabetic retinopathy


1 Department of Ophthalmology, Sankara Nethralaya, Kolkata, West Bengal, India
2 M N Eye Hospital.Pvt.Ltd, Chennai, Tamil Nadu, India

Date of Web Publication9-Mar-2018

Correspondence Address:
Dr. Kumar Saurabh
Department of Vitreoretina, Sankara Nethralaya, 147, Mukundpur, E. M. Bypass, Kolkata - 700 099, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_29_17

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  Abstract 


This is a case report of a 47-year-old male patient , a diabetic who presented with gradual loss of vision in both eyes. He had a combination of central serous retinopathy with diabetic retinopathy. Retinal laser was not possible due to exudative retinal detachment posing a therapeutic dilemma.

Keywords: Central serous retinopathy, diabetic retinopathy, retinal pigment epithelial rip


How to cite this article:
Saurabh K, Roy R, Nivean M. Exudative retinal detachment and retinal pigment epithelial rip due to central serous retinopathy in eye with diabetic retinopathy. TNOA J Ophthalmic Sci Res 2017;55:231-2

How to cite this URL:
Saurabh K, Roy R, Nivean M. Exudative retinal detachment and retinal pigment epithelial rip due to central serous retinopathy in eye with diabetic retinopathy. TNOA J Ophthalmic Sci Res [serial online] 2017 [cited 2019 Jul 17];55:231-2. Available from: http://www.tnoajosr.com/text.asp?2017/55/3/231/226862




  Introduction Top


A 47-year-old gentleman presented with gradual dimness of vision in his both eyes. He was known diabetic on insulin. He had been fighting a legal battle in the court of law for job-related issues for the past 6 years. The best-corrected visual acuity in the right and left eye were 20/80 and 20/60, respectively. Anterior segment was unremarkable in both eyes.

The right eye had retinal pigment epithelial atrophy at macula and few retinal hemorrhages near superior vascular arcade [Figure 1]. The left eye had retinal pigment epithelial atrophy with retinal hemorrhages and hard exudates at macula [Figure 1]. Inferior fundus in both eyes revealed nonrhegmatogenous exudative retinal detachment reaching up to inferior vascular arcade [Figure 2] and [Figure 3]. Fundus fluorescein angiogram of the right eye revealed large window defect at the covering the macula with leakage of dye near superior arcade [Figure 2]. It also showed well-circumscribed area of intense hyperfluorescence in temporal periphery suggestive of retinal pigment epithelial rip [Figure 2]. The left eye had retinal neovascularizations and had microaneurysms at posterior pole [Figure 3].
Figure 1: (a and b) Color fundus photograph of both eyes showing retinal pigment epithelial alteration (blank arrow) and retinal hemorrhages (solid arrow)

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Figure 2: Fluorescein angiogram montage of the right eye well-circumscribed area of hyperfluorescence in temporal periphery suggestive of retinal pigment epithelial rip (blank arrow) along with inferior retinal detachment (blank star). It also shows large window defect at macula with leak at superior margin (solid arrow)

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Figure 3: Fluorescein angiogram montage of the left eye showing bright hyperfluorescence along retinal vessel suggestive of retinal neovascularization (blank arrow) and inferior retinal detachment (blank star)

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In view of the history of undue mental stress combined with exudative retinal detachment in both eyes and large window defect in right eye along with retinal pigment epithelial rip; the patient was diagnosed to have central serous retinopathy. He also had nonproliferative diabetic retinopathy in the right eye and proliferative diabetic retinopathy in the left eye.


  Discussion Top


Persons having undue mental stress are predisposed to develop central serous retinopathy.[1] Our patient had a combination of central serous retinopathy with diabetic retinopathy posing a therapeutic dilemma. Retinal laser was not possible due to exudative retinal detachment. The patient was advised to avoid undue mental stress. He was advised to review back after 2 weeks for the reassessment of his eyes; however, he did not turn up for review as yet.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: Update on pathophysiology and treatment. Surv Ophthalmol 2013;58:103-26.  Back to cited text no. 1
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  [Figure 1], [Figure 2], [Figure 3]



 

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