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Editor,—Central serous chorioretinopathy (CSC) is a common idiopathic condition which predominantly affects middle aged men. We report an atypical case in a women which was unusual on two counts—frequent cyclical episodes governed by the menstrual cycle and the presence of significant cystoid macular oedema. To our knowledge, neither phenomenon has been previously described.
CASE REPORT
A 45 year old premenopausal white female presented with a 1 year history of intermittent blurring of central vision in her right eye. The left eye was blind following a penetrating eye injury as a child. Apart from low grade bronchiectasis with infrequent exacerbations she was otherwise well and took no regular medication. Initial clinical examination revealed a small area of neurosensory retinal detachment inferonasal to the fovea and cystoid macular oedema. There was no evidence of intraocular inflammation and the vitreous was clear. Fundus fluorescein angiography (FFA) taken during a symptomatic period showed three parafoveal areas of intraretinal oedema with small cystic spaces surrounding larger “petaloid” spaces typical of cystoid macular oedema (Fig 1A).
Late fluorescein angiograms of the right macula taken at 13 minutes. During a period of poor subjective vision and before hormone therapy there is significant cystoid macular oedema (CMO) with a typical petaloid pattern surrounded by three areas of outer retinal oedema (A). After 4 months of continuous hormone therapy with Mercilon there is no evidence of …