Severe types of central serous chorioretinopathy (CSC) have a chronic and persisting nature. Multimodal imaging presently allows thorough documentation of apparently quiescent phases, as well as acute exudative episodes. Limited information concerning long-term natural history of severe CSC is available in the literature. The purpose of the Authors is to report clinical and multimodal imaging features of a bilateral, severe case of CSC, to our knowledge along a yet unreported follow-up span of 15 years.


The authors reviewed clinical and imaging characteristics, visual outcomes, and complications concerning a 48 year old male caucasian patient, affected by chronic Central Serous Chorioretinopathy (CSC). The most severe manifestation during 15 years of follow-up was a bullous retinal detachment due to a giant RPE tear in the right eye, treated at our institution with PDT. PDT was administered to the areas of CSC leakage and to the area or the RPE tear using standard dosage and fluence. Following PDT residual signs of intraretinal exudation were treated with anti-VEGF intavitreal injections.


Follow-up of this reported case of chronic CSC has now reached 15 years. Multimodal follow-up of the PDT-treatment of the severe bullous retinal detachment is 7 years. Visual acuity has remained good (20[/30) in the right eye, which experienced the bullous retinal detachment, with no exudative reactivations observed during 7 years. Visual acuity has remained excellent in the left eye (20/25), in spite of multiple, both intra- and sub retinal exudative relapses. The left eye is presently characterized by chronic, severe persistence of intraretinal fluid, in spite of good central vision, which might require PDT retreatment and/ or further anti-VEGF intavitreal injections.


A long-term multimodal follow-up of a severe case of chronic CSC is offered in this report, as well as 7 years follow-up after successful PDT treatment of a bullous exudative retinal detachment due to a large RPE rip. The overall functional prognosis seems favourable, also thank to multiple treatment modalities now available.

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Enrico Bertelli