Central serous chorioretinopathy (CSC) is characterized by a serous detachment of the neurosensory retina caused by focal or diffuse dysfunction of the retinal pigment epithelium. A patient with a leopard-spot pattern of yellow-orange subretinal deposits as a rare dramatic form of CSC is described.Methods
A 65 year-old man with severe chronic obstructive pulmonary disease and congestive heart failure noticed a poor visual acuity after waking up from a coma elicited by an acute exacerbation of COPD and need for ventilation treatment. He underwent a full ophthalmic exam and extensive imaging including fluorescein-angiography, OCT and the use of infrared and auto-fluorescent light.Results
In the ocular history there was prior cataract surgery because of severe subcapsular posterior cataract in both eyes. Visual acuity (VA) was reduced to counting fingers in the right eye and perception of light in the left eye. Fundoscopy showed a leopard-spot pattern of yellow-orange subretinal deposits in the posterior pole more pronounced in the right eye compared to the left. On FFA, the deposits were hypofluorescent with additional multiple pinpoint areas of hyperfluorescence spread over the posterior pole. Spectral OCT demonstrated a shallow detachment of the neurosensory retina with extensive intraretinal fluid and alternating atrophic areas and deposits at the level of the RPE which corresponded with hypo- and hyperfluorescent areas with autofluorescent light.Conclusion
Coarsely mottled or leopard-spot hyperpigmentation and secondary retinal detachment may develop as a rare dramatic complication in patients with CSC.