Ring retinal pigment epithelial window defect of the macula in central serous chorioretinopathy

Purpose: Central serous chorioretinopathy is usually a benign disorder, in which resolution of serous subretinal fluid and return to a visual acuity of 20/40 or better is the normal outcome. In unusual cases of central serous chorioretinopathy, chronic subretinal fluid can lead to permanent retinal pigment epithelial depigmentation. In this report, we describe a ring-like (bull's eye) pattern of retinal pigment epithelial atrophy associated with central serous chorioretinopathy. Methods: We examined eight patients (nine eyes) with central serous chorioretinopathy in whom retinal pigment epithelial window defects encircling the fovea developed. Results: The average duration of symptoms before recognition of a circular window defect was 6 years, Visual acuity at the time of documentation of the ring-like window defect was 20/40 or worse in seven of nine (77%) eyes, Although laser photocoagulation treatment was performed in six of the nine eyes, vision improved two or more lines in only one eye (17%). Conclusion: Chronic central serous chorioretinopathy can cause a ring-like (bull's eye) pattern of retinal pigment epithelial window defects encircling the fovea. This pattern of retinal pigment epithelial window defect when seen in patients with central serous chorioretinopathy may indicate that a patient has a more severe form of central serous chorioretinopathy.