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Macular scarring is formation of the fibrous tissue in place of the normal retinal tissue on the macular area of the retina which provides the sharpest vision in the eyes. It is usually a result of an inflammatory or infectious process.. [ 1 ]
Recently, central serous chorioretinopathy has been understood to be part of the pachychoroid spectrum. [5] [6] In pachychoroid spectrum disorders, of which CSR represents stage II, the choroid, the highly vascularized layer below the retina, is thickened and congested with increased blood vessel diameter, especially in the deep choroid (the so-called Haller's layer).
In the dry (nonexudative) form, drusen accumulates between the retina and the choroid, causing atrophy and scarring to the retina. In the wet (exudative) form, which is more severe, blood vessels grow up from the choroid (neovascularization) behind the retina which can leak exudate and fluid and also cause hemorrhaging. [citation needed]
[1] [2] [3] A unifocal area of acute-onset inflammation adjacent to an old chorioretinal scar is virtually pathognomonic for toxoplasmic chorioretinitis. [ 2 ] [ 3 ] Focal condensation of vitreous and inflammatory cells may be seen overlying the pale yellow or gray-white raised lesion in the posterior pole.
These lesions may be colored from grey-white to cream-shaded yellow. Other symptoms include scotomata and photopsia. In weeks to a month times the lesions begin to clear and disappear (with prednisone) leaving behind areas of retinal pigment epithelial atrophy and diffuse fine pigmentation (scarring).
Tractional retinal detachment occurs when scar tissue on the retina exerts a pulling force, leading to detachment. [ 6 ] [ 10 ] This is occurs in the absence of retinal tears or breaks and is most commonly associated with abnormal blood vessel growth due to proliferative diabetic retinopathy .
In all stages, focal choroidal excavation may occur, which probably represents a contraction of the choroid due to scarring processes. [7] Beyond the spectrum of pachychoroid disorders of the macula, pachychoroid phenotypes have also been described around the optic disc, causing fluid retention in the retina (peripapillary pachychoroid).
Chorioretinitis is an inflammation of the choroid (thin pigmented vascular coat of the eye) and retina of the eye. It is a form of posterior uveitis. Inflammation of these layers can lead to vision-threatening complications. If only the choroid is inflamed, not the retina, the condition is termed choroiditis. [1]