Hernández-Da Mota Sergio Eustolio
Servicio de Retina, Clínica David Unidad Oftalmológica, Morelia, Michoacán, México.
Cir Cir. 2016 Jul-Aug;84(4):309-12. doi: 10.1016/j.circir.2015.04.032. Epub 2016 Jan 28.
Central serous choroidopathy is a macular disease, usually with a self-limited and benign course, and predominantly affects male patients between 20 and 45 years old.
A 68 year-old female patient complained of decreased visual acuity of her right eye of approximately 3 weeks of onset. Best corrected visual acuity in her right eye was 20/100. Fundus examination revealed a macular serous detachment involving its centre, as well as the presence of multiple calcified drusen. Fluorescein angiography showed late parafoveal leakage in a "smokestack" pattern in the right macular area. Optical coherence tomography showed a dome-shape macular detachment, also in the right eye. The patient was observed every 2 weeks and spontaneous resolution of the macular detachment was seen a month later. Based on these clinical features, a diagnosis was made of central serous choroidopathy of atypical presentation.
Atypical presentation cases of serous central choroidopathy might be seen occasionally. Hence, it is an important differential diagnosis of age related macular degeneration in patients older than 60 years.
中心性浆液性脉络膜病变是一种黄斑疾病，通常病程呈自限性且为良性，主要影响20至45岁的男性患者。
一名68岁女性患者主诉右眼视力下降约3周。其右眼最佳矫正视力为20/100。眼底检查发现黄斑中心浆液性脱离，以及多个钙化性玻璃膜疣。荧光素血管造影显示右眼黄斑区晚期在黄斑小凹周围呈“烟囱”样渗漏。光学相干断层扫描显示右眼也为穹窿形黄斑脱离。每2周对该患者进行观察，1个月后黄斑脱离自行消退。基于这些临床特征，诊断为非典型表现的中心性浆液性脉络膜病变。
浆液性中心性脉络膜病变的非典型表现病例可能偶尔会出现。因此，对于60岁以上患者，它是年龄相关性黄斑变性的重要鉴别诊断。
