DR AVADHESH OLI

Abstract

A 45-year-old patient underwent scleral tear repair following injury with a squash racket 1 wk back. He was started on oral and topical steroids. His BCVA improved from PL to 6/18 at the end of 2 wk. He developed subretinal fluid in the 3rd wk which was confirmed on OCT. Steroid induced CSCR was the first differential however possibility of a peripheral break and rare chance of sympathetic ophthalmia could not be ruled out completely. On autofluorescence hyper AF around the fluid was noted with 2 small areas of RPE atrophy which on the OCT scan appeared like RPE apertures. FFA confirmed the findings of CSCR & did not show hot disc. The oral steroids were stopped, & topical drops were tapered. To complicate the matters further the patient refused to stop smoking. Over a period of 2 wks the fluid slowly reduced with improvement in visual acuity.

This case highlights rare occurrence of CSCR post trauma with RPE tear and dilemma to stop steroids for prophylaxis of sympathetic ophthalmitis