Serous macular detachment secondary to distant retinal vascular disorders

PURPOSE: To report tomographic features of macular edema associated with distant retinal vascular disorders. METHODS: Six eyes with macular edema (three with extramacular branch retinal vein occlusion and three with Coats disease) underwent fluorescein angiography to detect dye leakage and optical coherence tomography to evaluate the macular features and measure the foveal height (distance between inner retinal surface and retinal pigment epithelium) and the retinal thickness (thickness of neurosensory retina) at the central fovea. RESULTS: Fluorescein angiography showed widespread nonperfusion and retinal vein staining in the eyes with a branch retinal vein occlusion not involving the macula. In eyes with Coats disease, nonperfused areas, telangiectatic retinal vessels, and aneurysms were seen in the peripheral fundus on fluorescein angiography. In one eye with Coats disease, telangiectatic vessels and aneurysms were seen in the nasal mid periphery of the optic disk. There was no dye leakage in the macular area in any eyes. Optical coherence tomography showed subretinal fluid and retinal swelling at the fovea in all eyes. The foveal height ranged from 300 to 697 microm (mean, 478 microm) and retinal thicknesses ranged from 170 to 280 microm (mean, 233 microm). CONCLUSION: Distant retinal vascular leakage causes serous retinal detachment in the macula. The macula is predisposed to collect subretinal fluid although retinal vascular leakage is far from the macula.