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肾移植后中心性浆液性脉络膜视网膜病变。

Central serous chorioretinopathy after renal transplantation.

机构信息

Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Retina. 2011 Oct;31(9):1896-903. doi: 10.1097/IAE.0b013e31820a69ee.

Abstract

PURPOSE

To describe the demographic and clinical characteristics of central serous chorioretinopathy (CSC) after renal transplantation (RT).

METHODS

A retrospective medical chart review was performed on 451 among 2,980 patients, who underwent RT and visited vitreoretinal clinic at Yonsei Medical Center from 1979 to 2009. Correlation between daily corticosteroid dosage and remission time and factors relating to final visual acuity of <20/40 were studied.

RESULTS

Twenty-eight patients (39 eyes) developed CSC at a median of 63 months after RT (range, 2 months to 20 years), and 18 (64%) patients were men. Accordingly, the prevalence of CSC after RT was estimated to be between 1% and 6%. All patients received a combination of corticosteroid and at least one other immunosuppressant agent at presentation. Reducing the daily corticosteroid dosage by 25% to 50% in CSC with classic pattern resulted in twice as faster remission (2 months) compared with the maintained dosage group (P = 0.025). Central serous chorioretinopathy recurrence (P = 0.002), intrinsic renal disease as cause of RT (P = 0.003), severe CSC variant (P = 0.009), and presenting visual acuity <20/40 (P = 0.009) predicted a final visual acuity <20/40.

CONCLUSION

Central serous chorioretinopathy develops relatively often after RT and varies in presentation and severity. The cause of CSC after RT appears to be multifactorial and closely related to corticosteroid.

摘要

目的

描述肾移植(RT)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。

方法

对 1979 年至 2009 年间在延世医疗中心接受 RT 并接受玻璃体视网膜门诊治疗的 2980 名患者中的 451 名进行了回顾性病历审查。研究了每日皮质类固醇剂量与缓解时间之间的相关性,以及与最终视力<20/40 相关的因素。

结果

28 例(39 只眼)在 RT 后中位数为 63 个月(范围 2 个月至 20 年)时发生 CSC,18 例(64%)为男性。因此,RT 后 CSC 的患病率估计在 1%至 6%之间。所有患者在就诊时均接受皮质类固醇和至少一种其他免疫抑制剂的联合治疗。与维持剂量组相比,具有经典模式的 CSC 中,将每日皮质类固醇剂量减少 25%至 50%可使缓解时间快一倍(P=0.025)。CSC 复发(P=0.002)、RT 的固有肾脏疾病原因(P=0.003)、严重 CSC 变异(P=0.009)和就诊时视力<20/40(P=0.009)预测最终视力<20/40。

结论

CSC 在 RT 后相对常见,其表现和严重程度不同。RT 后 CSC 的病因似乎是多因素的,与皮质类固醇密切相关。

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