Intrathecal Fluorescein for Serous Macular Detachment

Abstract

To the Editor. —Serous detachment of the macula is a frequent complication of congenital pits of the optic disc, but the source of the subretinal fluid remains unknown. Suga^r postulated that fluid traveled from the vitreous cavity through the pit to the subretinal space, while Regenbogen and associates² suggested that cerebrospinal fluid might leak from the subarachnoid space through the pit to detach the macula. Gass³ presented fluorescein angiographic evidence that the subretinal fluid did not leak from retinal, choroidal, or optic nerve circulations; histochemical studies showed no evidence that the subretinal fluid was derived from the vitreous cavity. He suggested intrathecally injected fluorescein as a possible diagnostic method for a subarachnoid-subretinal fistula, a possibility recently reintroduced into the literature.⁴ We attempted to use this technique with one patient in 1969 and produced neurologic events that fortunately were transient. A young soldier was seen with reduced