ACUTE BILATERAL RETINAL AND CHOROIDAL DETACHMENT-A CASE REPORT.
Aliénor Vienne-Jumeau, Adélaïde Toutée, Samira Zegrari et al.
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Case in brief
A 57-year-old man developed profound bilateral visual loss while hospitalized with sepsis of unknown cause and was referred three weeks later with bilateral retinal detachment. Fundoscopy and echography showed annular retinal and choroidal detachments; an extensive workup was negative. Steroid boluses for suspected uveal effusion syndrome produced minimal improvement after five days. Multimodal imaging then showed fluorescein-hyperfluorescent spots with corresponding subretinal hyperreflective material, suggesting fibrin, and adjacent serous detachment. After the spots were treated with laser photocoagulation, the detachments gradually resolved, with progressive visual recovery and complete central serous detachment resolution over seven months.
What made this case unusual
The presentation combined acute bilateral annular retinal and choroidal detachment with central serous chorioretinopathy-like imaging features. The slow, dramatic anatomical and visual recovery was atypical for both uveal effusion syndrome and central serous chorioretinopathy.
Diagnostic / clinical pearl
In bilateral retinal and choroidal detachment with limited response to steroids, multimodal imaging may reveal focal hyperfluorescent lesions and corresponding subretinal material that help identify a treatable component.
Why it matters
This case illustrates that type-3 uveal effusion syndrome can present with central serous chorioretinopathy-like features; the authors considered multifocal laser photocoagulation potentially beneficial.