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Case 26

Contributor: Dr. Sultan Aldrees, MD

Patient Presentation: A 53-year old male presents to the emergency department with blurry vision in his right eye for 3 days. He denies a history of trauma. His past medical history is significant for eczema, asthma, hypercholesterolemia, and hypertension.  His medication list includes: Telmesartan, Flovent and Crestor. On examination, his vision is 20/30 in each eye, he has no afferent pupillary defect and he has normal intraocular pressures. Slit lamp exam is unremarkable and fundus exam shows blunted foveal reflex in the right eye. OCT macula of the right eye is performed and demonstrates the following:

Retina 26-1.png

Question: Based on this OCT what is your diagnosis?

Question: What in the history may have an association to the development of CSCR?

Question: What is the most common and most characteristic IVFA patterns in cases of CSCR?

Question: Which of the following can be used for the management of CSCR?

Retina 26-3.png

Question: You saw a patient earlier in the day with the same diagnosis. The OCT macula of this patient is shown to the left. What is the abnormality indicated by the yellow arrow?

Learning Objectives:

1. Identify the OCT features of CSCR

2. Understand the cause of "brush border pattern" in CSCR

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