SUBRETINAL FIBROSIS AND NONRHEGMATOGENOUS RETINAL-DETACHMENT ASSOCIATED WITH MULTIFOCAL CENTRAL SEROUS CHORIORETINOPATHY

Purpose: To report the rare occurrence of subretinal fibrosis in patie nts with multifocal central serous chorioretinopathy and evaluate the role of systemic corticosteroids and the effects of laser photocoagula tion on multifocal leaks. Methods: A total of 29 patients (mean age, 3 7.7 years; 89.7% male) treated for subretinal fibrosis and multifocal central serous chorioretinopathy from 1983-1995 were reviewed retrospe ctively. Mean follow up was 26 months (range, 6.8-81 months). Results: Retinal detachment involved the macula in 72.4% cases. Fluorescein an giography showed a mean of 6.7 (range, 2-22) central serous chorioreti nopathy leaks acid a mean of 1.8 (range, 1-5) retinal pigment epitheli al detachments. The fundus pictures of 23 patients who were taking sys temic corticosteroids showed no improvement. Following laser treatment , however, retinal reattachment was obtained in all eyes, and improvem ent in visual acuity of > 2 Snellen lines was noted in 68.9% of patien ts. Conclusions: The presence of subretinal fibrosis with secondary re tinal detachment in otherwise healthy young patients, particularly in men, should alert the physician to look for multifocal central serous retinopathy leaks. Systemic cortiosteroids did not prove effective in treating these patients, although laser treatment is recommended for e ach leak identified on an angiogram.