How do macular degeneration and serous retinopathy differ?

Question

Hello doctor,

I am 44 years old. 15 days ago, my left eye vision started getting distorted. I have no pain, and I never had any eye problem nor did anyone in my family. I went to the doctor, and the doctor did not give me any diagnosis so far. After a few scans, first one was taken 10 days ago and the last one today, he could not decide between wet macular degeneration, as he spotted a small blood spot in the center of the macula, and central serous retinopathy. He suggested the treatment with injection. I am very scared and very frustrated as I do not have a diagnosis yet. Can you please help me with a second opinion? Thank you so much.

Answer 1

Hello,

Welcome to icliniq.com.

It is very difficult to comment without examining your retina or your scans. As you mentioned there was blood at the fovea, this is suggestive of wet AMD (age-related macular degeneration) rather than CSR (central serous retinopathy). Moreover, injection is advised for AMD and not for CSR. Having said that, it is a provisional diagnosis. Kindly share your scan reports, so that I can guide you better. Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

I reviewed your reports (attachment removed to protect patient identity) with great patience. I agree with your treating ophthalmologist that this is indeed a confusing clinical situation. I discussed your reports and clinical symptoms with my retina colleagues also, and we all had the following conclusion. To us, all though there was a dilemma between wet ARMD and CSR, the diagnosis tilted towards wet ARMD because of the following reason, one is the presence of blood drop at fovea is very significant, as I discussed earlier also and other is OCT (optical coherence tomography) findings are again very confusing and do not pin point towards a particular diagnosis. FFA (fundus fluorescein angiography) would have been useful, but you shared only one frame of FFA. I would request you to share all frames of FFA as a single frame does not give clear information. We will review the reports and will guide you through.Regards.