Acute bilateral retinal and choroidal detachment - A case report.

PURPOSE: To report an unusual episode of acute bilateral retinal and choroidal detachment.

METHODS

Case report.

RESULTS

We report the case of a fifty-seven-year-old male referred to the emergency department for an acute bilateral retinal detachment. He had experienced profound visual loss three weeks earlier while hospitalized for sepsis of unknown cause. Fundoscopy revealed bilateral annular retinal and choroidal detachment, confirmed by echography. An extensive work-up was negative, and the patient was given steroid boluses for suspected uveal effusion syndrome, although the axial length was normal. After five days of steroid treatment, minimal improvement was observed. The treatment was discontinued, and new multimodal imaging revealed a hyperfluorescent spot on fluorescein angiography (FA) in the right eye with subretinal hyperreflective material on corresponding optical coherence tomography suggesting fibrin and adjacent serous detachment. The spot was treated with laser photocoagulation, and the retinal detachment started to decrease two days later. Additional hyperfluorescent spots were later found and treated with laser photocoagulation. Over a few weeks, both functional and anatomical improvements were observed. Over the course of seven months, the central serous retinal detachment slowly and completely resolved while vision progressively and dramatically improved. This very slow and dramatic anatomical and functional improvement was atypical for both uveal effusion syndrome and central serous chorioretinopathy.

CONCLUSIONS

This atypical case of type-3 uveal effusion syndrome presented as acute bilateral retinal and choroidal detachment with central serous chorioretinopathy-like features. Multifocal laser photocoagulation may have improved both functional and anatomical outcomes, with dramatic recovery after seven months.