DR. ANAND SINGH BRAR

DR.SRIKANTA KUMAR PADHY

Abstract

36-year-old male had gradual diminution of vision in both eyes for last 9 years which was ascribed to chronic central serous chorioretinopathy (CSC). Fundus examination revealed shallow neuro-sensory detachment at the macula with diffuse pigment mottling. Best corrected visual acuity was 20/20 (OU). He had no family history of similar retinal disease. The provisional diagnosis of CSC was challenged when the subretinal fluid appearance was unchanged in the next follow-up. Alternative diagnosis was considered after examining the auto-fluorescence/optical coherence tomography, and electrophysiological tests were conducted. Sub-normal electro-retinography and absence of light rise on electro-oculography further strengthened suspicion of autosomal-recessive bestrophinopathy (ARB). Genetic analysis established the definite diagnosis of ARB. This case highlights the importance of identifying ARB masquerading as CSC, as the natural course, prognosis and management are disparately different.