Resolution of choroidal effusion and serous retinal detachment after PASCAL photocoagulation in a patient with diabetic retinopathy.

Abstract

To present a rare case of PASCAL photocoagulation-induced choroidal effusion and serous retinal detachment in a patient with diabetic retinopathy. A case report. A 68-year-old man with type 2 diabetes mellitus presented with decreased vision in both eyes. His best corrected visual acuity (BCVA) was 0.39 logMAR units in both eyes. The patient underwent panretinal photocoagulation (PRP) in two quadrants of both eyes on the same day according to his fundus fluorescein angiography. Three days after the first session of PRP, the BCVA in his left eye deteriorated by 2.0 logMAR units. Fundoscopic examination detected a significant choroidal effusion in inferonasal quadrant of the left eye. A macular Spectral-Domain Optical Coherence Tomography (SD-OCT) scan showed a large macular serous retinal detachment in the left eye. Topical steroid, topical cycloplegic, and 64 mg oral methylprednisolone were initiated. Two weeks later, his BCVA returned to the level of the first visit with a completely resolved choroidal effusion and no subretinal fluid. Considering the inflammatory and destructive mechanism of PRP, the laser operator should use the minimum power necessary to avoid possible chorioretinal complications.