First Author: M.Katta UK
Co Author(s): T. Kwok
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Central serous chorioretinopathy (CSCR) is an accumulation of subretinal fluid with detachment of the neurosensory retina mainly found in young caucasian males. Presented here is the first case reported of a twelve year old girl with idiopathic bilateral CSCR including optical coherence tomography (OCT), Fluorescein and Indocyanine Green fundus angiography (FFA and ICGA) with a literature search on how best to manage these paediatric cases.
This case presented to a busy district general eye casualty after referral by an optician.
Full ophthalmic assessment was conducted including blood test work up, OCT, FFA and ICGA. She was followed up for a total 8 months.
This twelve year old Caucasian girl presented with bilateral visual blurring with no medical history. Best corrected visual acuity was 6/18 bilaterally. There was more marked retinal elevation in the right eye with approximately two disc diameter involvement. OCT confirmed the diagnosis with neurosensory detachment. FFA and ICGA did not show any active leaking in either eye. Blood workup was all normal including inflammatory markers and morning cortisol level. Vision improved without active treatment to 6/5 bilaterally at her three month review with OCT resolution and remains so at 8 months post presentation. A literature search of the MEDLINE database revealed three other paediatric cases of CSCR, most of which resolved spontaneously. The widely agreed management appears to be observation for at least 3 months at which point photodynamic therapy can be considered if resolution has not occurred.
It would appear that cases of CSCR in children follow a similar course to that described in adults and the most appropriate initial treatment is watchful waiting. Should the disease take a more chronic or recurrent form after three months the evidence points slightly in the favour of PDT as the next line of management, and most likely better tolerated by children.