PMC4251634_01
(a) Red-free photograph shows the right eye before thermal laser therapy with a large macular serous retinal detachment measuring about 4 disc diameters. (b) Early fluorescein angiography (FA) phase shows a small pinpoint area of retinal pigment epithelium (RPE) leak superonasal to the fovea. (c) Midphase fluorescein angiography (FA) shows an increase in the small focal area of RPE leak superonasal to the fovea. (d) Late phase FA shows an increase in the superonasal focal hyperfluorescence with an inkblot-like leakage pattern.
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fig1
Argon laser has been applied directly to the fluorescein angiographic (FA) leakage site in the RE (Figure 1).
(a) Color photograph of the right eye two days after focal thermal laser. At initial examination, visual acuity (VA) was 20/200 (ETDRS chart) and a subretinal subfoveal hemorrhage with the greatest linear diameter (GLD) of 4.500 mu was seen. (b) Color photograph after pneumatic displacement with intravitreal tissue plasminogen activator (IVTPA) combined with pure C3F8. At 24 hours, the hemorrhage had been displaced inferiorly and VA improved to 20/100. Two weeks after pneumatic displacement with C3F8 and IVTPA, VA improved to 20/80.
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fig2
At initial examination, VA was 20/200 (ETDRS chart) and a subretinal subfoveal hemorrhage with the greatest linear diameter (GLD) of 4.500 mu was seen (Figure 2(a)). IVTPA, VA improved to 20/80, CMT decreased to 225 mu, and GLD of the hemorrhage decreased to 2000 mu without foveal involvement (Figures 2(b) and 3(b)). In addition, OCT demonstrates a hyperreflective fusiform elevation of the RPE/choriocapillaris complex that seems to correspond to fibrosis tissue at the thermal laser site.
(a) Optical coherence tomography (OCT) revealed an increased central macular thickness (CMT) of 398 mu with loss of foveal architecture and subretinal hemorrhage with a neurosensory retinal detachment. (b) Two weeks after pneumatic displacement with C3F8 and intravitreal tissue plasminogen activator, visual acuity improved to 20/80 and CMT decreased to 225 mu. A hyperreflective fusiform elevation of the retinal pigment epithelium/choriocapillaris complex that seems to correspond to fibrosis tissue is seen at the thermal laser site. A small subfoveal neurosensory retinal detachment persists. However, there is normalization of the foveal architecture.
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fig3
Optical coherence tomography (OCT) revealed an increased central macular thickness (CMT) of 398 mu with loss of foveal architecture and subretinal hemorrhage with a neurosensory retinal detachment (Figure 3(a)). However, there is normalization of the foveal architecture (Figure 3(b)).