Atypical chronic central serous chorioretinopathy with cystoid macular edema: Therapeutic response to medical and laser therapy

To describe an atypical case of chronic central serous chorioretinopathy (CSCR).
A 58-year-old man with longstanding, bilateral visual impairment was self-referred for a second opinion.
Findings by direct ophthalmoscopy, optical coherence tomography, fluorescein angiography, and fundus autofluorescence (FAF) were suggestive of atypical, chronic CSCR. Treatment with oral anti-mineralocorticoids resulted in moderate improvement, and photodynamic therapy (PDT) had minimal effect.
Chronic CSCR may lack cardinal features of CSCR. Once retinal degenerative changes ensue, current treatments may not be effective in improving anatomical and visual outcomes in patients with chronic CSCR.