A 32-year-old man presents with blurred vision in the right eye for two weeks. He recently completed a course of oral corticosteroids for an allergic rash. Fundoscopy shows a well-circumscribed serous elevation of the sensory retina at the posterior pole with a small round depigmented spot temporal to the fovea. The retina shows no haemorrhages or vascular changes. What is the MOST appropriate initial management?

• A Intravitreal anti-VEGF injection
• B Immediate panretinal photocoagulation
• C Observation with discontinuation of corticosteroids, as most cases resolve spontaneously in three to six months ✓
• D Oral acetazolamide for six months

Explanation

This is central serous chorioretinopathy, a disease of young men characterised by serous detachment of the sensory retina from choroidal hyperpermeability, often triggered by systemic or local corticosteroids. It is self-limiting in most patients over three to six months, so observation and withdrawal of steroids is correct first-line care. Anti-VEGF targets choroidal neovascularisation, not this condition, and photocoagulation is reserved for persistent leaks away from the fovea.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.