Case report demonstrates targeted laser resolves exudative macular detachment in a male with CSC.
We report a case of a 42-year-old male with chronic central serous chorioretinopathy (CSC) complicated by an exudative macular detachment and a micro-retinal pigment epithelium (RPE) rip. Multimodal imaging confirmed the diagnosis, with fluorescein angiography demonstrating a pinpoint leak with a classic “smoke-stack” plume of fluorescein; optical coherence tomography revealed subretinal fluid (SRF) with fibrinous exudates (turbid fluid), underlying pachychoroid features, and a small focal RPE rip. We performed targeted macular laser directly to the micro-RPE rip after titrating to a barely visible burn. At the eight-week follow-up, the SRF had completely resolved with a reduction of RPE elevation and visual acuity improvement. This case illustrates the successful use of a focal laser in a CSC variant with an RPE micro-tear, leading to resolution of exudative macular detachment and visual improvement.
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Soliman et al. (2025) studied this question.
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