A 46-year-old man, who had had idiopathic multiple serous retinal pigment epithelial detachments (PEDs)1 bilaterally for more than 7 years (Figure 1), also had a bullous retinal detachment2,3 accompanied by fibrinous exudates in the left eye (Figure 2A). We detected the leakage point at the edge of the largest PED in the macular area (Figure 3A). Extensive leakage in the middle phase of fluorescein angiography (Figure 3B) represented the clear space surrounded by fibrinous exudates (Figure 2A). We applied laser photocoagulation to the leakage point. Two weeks later, the fibrinous exudates decreased slightly (Figure 4A). Three-dimensional optical coherence tomography (OCT) (OCT-Ophthalmoscope; Ophthalmic Technologies, Inc, Toronto, Ontario), which can provide transverse en face retinal images at different depths,4,5 showed isolated clear spaces surrounded by high intensity corresponding to multiple PEDs in the superficial layers of the subretinal space (Figure 4C). Posterior consecutive transverse images detected multiple contiguous PEDs in the deeper levels (Figure 4 C-F). Fibrinous exudates and serous fluid adjacent to the edge of the largest PED, which had joined with other PEDs, were seen as areas of moderate and dark intensity in the macular area (Figure 4E). The fibrinous exudates completely disappeared 5 months later. The largest PED in the macular area disappeared, and small PEDs at the temporal macular area became indistinct (Figure 2B).
Sawa M, Gomi F, Harino S, Ohguro N, Ohji M, Tano Y. Three-dimensional Optical Coherence Tomographic Findings of Idiopathic Multiple Serous Retinal Pigment Epithelial Detachment. Arch Ophthalmol. 2005;123(1):122-123. doi:10.1001/archopht.123.1.122