Purpose: Central serous chorioretinopathy is usually a benign disorder
, in which resolution of serous subretinal fluid and return to a visua
l acuity of 20/40 or better is the normal outcome. In unusual cases of
central serous chorioretinopathy, chronic subretinal fluid can lead t
o permanent retinal pigment epithelial depigmentation. In this report,
we describe a ring-like (bull's eye) pattern of retinal pigment epith
elial atrophy associated with central serous chorioretinopathy. Method
s: We examined eight patients (nine eyes) with central serous choriore
tinopathy in whom retinal pigment epithelial window defects encircling
the fovea developed. Results: The average duration of symptoms before
recognition of a circular window defect was 6 years, Visual acuity at
the time of documentation of the ring-like window defect was 20/40 or
worse in seven of nine (77%) eyes, Although laser photocoagulation tr
eatment was performed in six of the nine eyes, vision improved two or
more lines in only one eye (17%). Conclusion: Chronic central serous c
horioretinopathy can cause a ring-like (bull's eye) pattern of retinal
pigment epithelial window defects encircling the fovea. This pattern
of retinal pigment epithelial window defect when seen in patients with
central serous chorioretinopathy may indicate that a patient has a mo
re severe form of central serous chorioretinopathy.