Wang Maria, Sander Birgit, la Cour Morten, Larsen Michael
Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol Scand. 2005 Dec;83(6):691-6. doi: 10.1111/j.1600-0420.2005.00582.x.
To describe abnormal subretinal material in central serous chorioretinopathy (CSC).
Retrospective observational case series.
168 consecutive patients (336 eyes) with a definite diagnosis of serous foveal detachment attributable to CSC in one or both eyes, on one or more occasions.
Review of all cases seen during a six-year period. Grading of the amount of subretinal material at presentation as absent, questionable, mild, moderate or severe.
Of 168 patients with CSC, 133 (79%) were men and 35 (21%) women. The median age was 45.2 years (range 22-70 yrs). The median duration of symptoms was 2 months (range 0.1-144 months). Subretinal material was found in the symptomatic eye or, in bilateral cases, in the eye that had most recently become symptomatic in 138 patients and in increasing amounts with increasing duration of symptoms (p < 0.001) but unrelated to age or sex. A substantial fraction of the material was shown by optical coherence tomography to be attached to the photoreceptor outer segments of the detached retina.
Increasing amounts of subretinal material are found with increasing duration of symptoms in eyes with CSC. This suggests that early granular deposits may be composed of fragments of photoreceptor outer segments that accumulate when the phagocytosis photoreceptor outer segment material is disrupted by the serous detachment of the retina. Other possible origins that cannot be excluded include plasma proteins excluding from the choriocapillaris, inflammatory debris, and lipid exudate originating from occult choroidal neovascularization secondary to CSC.
描述中心性浆液性脉络膜视网膜病变（CSC）中的异常视网膜下物质。
回顾性观察病例系列。
168例连续患者（336只眼），明确诊断为一只或两只眼睛因CSC导致浆液性黄斑脱离，有一次或多次发作。
回顾六年期间所见的所有病例。将就诊时视网膜下物质的量分级为无、可疑、轻度、中度或重度。
168例CSC患者中，133例（79%）为男性，35例（21%）为女性。中位年龄为45.2岁（范围22 - 70岁）。症状的中位持续时间为2个月（范围0.1 - 144个月）。在138例患者的患眼中发现了视网膜下物质，在双眼患病的情况下，在最近出现症状的眼中发现了视网膜下物质，且随着症状持续时间的增加，其数量也增加（p < 0.001），但与年龄或性别无关。光学相干断层扫描显示，相当一部分物质附着于脱离视网膜的光感受器外段。
CSC患者眼中，随着症状持续时间的增加，视网膜下物质的量也增加。这表明早期颗粒状沉积物可能由光感受器外段的碎片组成，当视网膜浆液性脱离破坏光感受器外段物质的吞噬作用时，这些碎片会积聚。不能排除的其他可能来源包括脉络膜毛细血管渗出的血浆蛋白、炎性碎屑以及CSC继发的隐匿性脉络膜新生血管形成产生的脂质渗出物。
