AA case of the week

The above are photographs of the patients right and left eyes. RVA 6/60 and LVA 6/9. 

The last 2 images were taken post-anti-VEGF treatment.

Questions

1) What is the diagnosis?

2) What is the recommended treatment?

3) Why did we treat the right eye as we did?

Answers

CSR in both eyes, (chronic in RE)

Cases of recent onset - observation

Chronic or special cases (eg One eye) 

Treatment if chronic: PDT (risk of failure), anti-VEGF (to reducing vascular leakage)

RE was treated with lucentis with VA improving to 6/9. 

The LE resolved spontaneously after 2 months


Discussion
CSR is usually self limiting and in most cases resolves spontaneously within a ~3-month period.

Chronic cases, such as those lasting ~6 months,might cause progressive damage to the photoreceptors and RPE causing permanent visual disturbance/loss. So PDT/anti-VEGF treatments should be considered.