Grand Rounds
This is a case of a young man with central serous choroidopathy (CSC) who presented for dysmorphopsia and color vision changes in the right eye. He was found to have subretinal fluid (SRF), RPE changes, pigment epithelial detachment (PED), and a thick choroid on optical coherence tomography (OCT) and was diagnosed with chronic CSC. Indocyanine Green Angiography (ICGA) showed venous congestion, choriocapillaris hyperpermeability, and intervortex anastomosis. He was treated with focal laser to the area of focal leakage as seen on Fluorescein Angiography (which corresponded to dilated anastomic vessels on ICGA) with resolution of symptoms and SRF. His contralateral healthy eye showed no choroidal thickening and no intervortex anastomosis which supports the pathophysiology theory that both pachychoroid and choroidal anastomosis are manifestations of venous overload choroidopathy rather than the root cause. Therefore, CSC seems to be one manifestation of the many diseases that occur due to choroidal venous overload similar to chronic venous insufficiency in other organ systems.
Presentation Date: 04/25/2024
Issue Date: 05/10/2024
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