Intrathecal Fluorescein for Serous Macular Detachment

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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. Sugar 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

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