Subretinal Fibrinous Exudative Material Identified in Central Serous Chorioretinopathy

Eye Test
CARDIFF, UNITED KINGDOM – APRIL 28: An optician carrying out an eye test using a Optical Coherence Tomography (OCT) machine on April 28, 2015 in Cardiff, United Kingdom. (Photo by Matthew Horwood/Getty Images)
A 38-week pregnant patient presents with central serous chorioretinopathy in 1 eye.

This article is part of Optometry Advisor’s conference coverage from the 2021 meeting of the American Academy of Optometry, held in Boston from November 3 to 6, 2021. The team at Optometry Advisor will be reporting on a variety of the research presented by the primary eye care experts at the AAO. Check back for more from the AAO Optometry 2021 Meeting..

Pregnant patients have an increased risk of central serous chorioretinopathy (CSCR), according to researchers. Subretinal fibrinous exudation, which does not tend to present in these cases, was found in a case report presented at the American Academy of Optometry 2021 meeting held November 3-6 in Boston.

Along with pregnancy, risk factors of CSCR also include systemic steroid use, collagen vascular disease, type A personality, and pregnancy. A study published in 2020 in Clinical Ophthalmology found that in patients older than 70 years, CSCR can appear in fluorescein angiography as occult neovascular age-related macular degeneration (nAMD). Treatments for CSCR include subthreshold micropulse laser treatment (SML), standard-fluence photodynamic therapy (PDT), and low-fluence PDT. 

Researchers at Nova Southeastern University evaluated a 38-week pregnant, 31-year-old Hispanic patient who reported new onset of constant blurry vision both at distance and near. Following an eye exam, her best corrected visual acuity was found to be 20/50, pinhole no improvement (PHNI) in her right eye and 20/20 in her left eye.

The researchers conducted diagnostic refraction and did not find hyperopic shift or improvement in vision. Through funduscopic exam, they found a large, yellow/white serous detachment of the macula.

They ran additional imaging tests including optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), fundus photography, and wide-field imaging. The investigators identified subretinal fibrinous exudative material in additional testing.

“Despite the high prevalence of CSCR reported in association with pregnancy, there are minimal reports of CSCR with concomitant subretinal fibrinous exudation,” the investigators said. “Hormonal imbalance results in morphological changes to the retina and overlying retinal pigment epithelium.”

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Ferraz M, Rousso L, Rodman J. Multimodal imaging of central serous chorioretinopathy with sub-retinal fibrinous exudation in a 38-week pregnant patient. Poster Presented at: American Academy of Optometry 2021 Annual Meeting; November 3-6, 2021; Boston. Board #114.