Perfluorocarbon Liquid-Assisted External Drainage in the Management of Central Serous Chorioretinopathy with Bullous Serous Retinal Detachment

The differential diagnosis of serous retinal detachment (RD) includes Vogt-Koyanagi-Harada syndrome, severe hypertensive choroidopathy, posterior scleritis, multifocal choroiditis, metastatic tumor, and uveal effusion. Some cases of serous retinal detachment occur as a result of central serous chorioretinopathy (CSCR). Typical CSCR generally affects healthy middle-aged males and is characterized by localized serous RD of the neurosensory retina and retinal pigment epithelium in the macula that often spontaneously improve within 2 to 3 months. On rare occasions, variant CSCR with bullous RD occurs which is frequently misdiagnosed. We report on a case of variant CSCR with severe bullous serous retinal detachment in the left eye that was initially treated at another hospital under the misdiagnosis of rhegmatogenous retinal detachment. Because the retinal detachment developed so fast that a laser could not be applied to all leaking spots, we performed a pars plana vitrectomy, perfluorocarbon liquid-assisted external drainage, and final treatment with an endolaser. The retina was well attached after this management.