Fawzi Amani A, Holland Gary N, Kreiger Allan E, Heckenlively John R, Arroyo Jorge G, Cunningham Emmett T
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Ophthalmology. 2006 May;113(5):805-13.e5. doi: 10.1016/j.ophtha.2006.01.031.
To describe the demographic and clinical characteristics of central serous chorioretinopathy (CSC) after solid organ transplantation.
Case series.
Fifteen patients who presented to the authors with CSC after solid organ transplantation.
We performed a retrospective chart review to identify patient demographics and clinical features of disease, including angiographic changes.
Patterns of CSC. These patterns were compared with type of organ received, demographics, and visual outcome.
We identified 25 eyes of 7 women (46.7%) and 8 men (53.3%) that developed CSC after solid organ transplantation. Patient ages ranged from 27 to 55 years (median, 40). Seven of the 15 patients (46.7%) were Caucasian, including 3 Hispanic patients (20%). Of the 8 remaining patients (53.3%), 2 were African American (13.3%), 2 were Filipino (13.3%), and 4 were Asian (26.7%). The organs received included 13 kidneys (86.7%), 1 liver (6.7%), and 1 heart (6.7%). Systemic hypertension was reported in 14 of 15 patients (93.3%). All patients were receiving systemic immunosuppressive drugs at presentation; 14 of 15 (93.3%) were also receiving systemic corticosteroids. Visual acuity at presentation ranged from 20/20 to counting fingers. Patterns of CSC included (1) geographic or diffuse alterations in the retinal pigment epithelium (5 eyes; 2 bilateral, 1 unilateral), (2) focal CSC (6 eyes, all unilateral), (3) multifocal CSC (6 eyes; 2 bilateral, 2 unilateral), and (4) CSC with bullous retinal detachment (8 eyes, all bilateral). Follow-up, available for 21 affected eyes of 13 patients, ranged from 1 month to 6 years (median, 12 months). Compared with other solid organ transplant recipients at our institutions, renal transplant recipients (P = 0.003), as well as Hispanic and Asian patients (P = 0.05), were more prevalent in this cohort.
Central serous chorioretinopathy after solid organ transplantation varies in presentation and severity. Our observations support a role for choroidal vascular compromise in the pathogenesis of this disorder.
描述实体器官移植后中心性浆液性脉络膜视网膜病变（CSC）的人口统计学和临床特征。
病例系列。
15例实体器官移植后出现CSC并就诊于作者处的患者。
我们进行了一项回顾性病历审查，以确定患者的人口统计学资料和疾病的临床特征，包括血管造影改变。
CSC的类型。将这些类型与所接受器官的类型、人口统计学资料及视力转归进行比较。
我们确定了15例患者中的25只眼发生了实体器官移植后CSC，其中7名女性（46.7%）和8名男性（53.3%）。患者年龄范围为27至55岁（中位数为40岁）。15例患者中有7例（46.7%）为白种人，包括3名西班牙裔患者（20%）。其余8例患者（53.3%）中，2例为非裔美国人（13.3%），2例为菲律宾人（13.3%），4例为亚洲人（26.7%）。所接受的器官包括13个肾脏（86.7%）、1个肝脏（6.7%）和1个心脏（6.7%）。15例患者中有14例（93.3%）报告有系统性高血压。所有患者就诊时均在接受全身性免疫抑制药物治疗；15例中有14例（93.3%）还在接受全身性皮质类固醇治疗。就诊时的视力范围从20/20到数指。CSC的类型包括：（1）视网膜色素上皮的地图状或弥漫性改变（5只眼；2例双侧，1例单侧），（2）局灶性CSC（6只眼，均为单侧），（3）多灶性CSC（6只眼；2例双侧，2例单侧），以及（4）伴有大泡性视网膜脱离的CSC（8只眼，均为双侧）。13例患者的21只患眼的随访时间为1个月至6年（中位数为12个月）。与我们机构的其他实体器官移植受者相比，肾移植受者（P = 0.003）以及西班牙裔和亚洲患者（P = 0.05）在该队列中更为常见。
实体器官移植后中心性浆液性脉络膜视网膜病变在表现和严重程度上存在差异。我们的观察结果支持脉络膜血管受损在该疾病发病机制中的作用。
