A 35-year-old hyperopic woman presents with Amsler grid distortion and a small serous pigment epithelial detachment at the fovea on OCT. EDI-OCT shows pachychoroid and dilated Haller layer vessels. Indocyanine green angiography confirms choroidal hyperpermeability. The most likely diagnosis is:
- A Central serous chorioretinopathy (CSCR) ✓
- B Wet (neovascular) AMD
- C Idiopathic polypoidal choroidal vasculopathy (PCV)
- D Vogt-Koyanagi-Harada disease (VKH)
Explanation
Central serous chorioretinopathy (CSCR) is characterised by focal serous detachment of the neurosensory retina or RPE at the posterior pole, typically in young to middle-aged type A personality males (or hyperopic women), with a history of stress or corticosteroid use. EDI-OCT demonstrates a thick choroid (pachychoroid) with dilated outer choroidal vessels (Haller layer), and ICGA confirms focal areas of choroidal hyperpermeability. Most acute cases resolve spontaneously in 3 months; chronic CSCR (>4 months) may be treated with low-fluence photodynamic therapy (PDT) or eplerenone.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.