Dansingani Kunal K, Balaratnasingam Chandrakumar, Mrejen Sarah, Inoue Maiko, Freund K Bailey, Klancnik James M, Yannuzzi Lawrence A
Vitreous Retina Macula Consultants of New York, New York, New York; The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Moorfields Eye Hospital, London, United Kingdom.
Vitreous Retina Macula Consultants of New York, New York, New York; The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York.
Am J Ophthalmol. 2016 Jun;166:60-67. doi: 10.1016/j.ajo.2016.03.025. Epub 2016 Mar 25.
To describe a series of patients exhibiting annular retinal pigment epithelial (RPE) lesions in the context of chronic central serous chorioretinopathy.
Retrospective comparative case series.
Consecutive patients with chronic central serous chorioretinopathy were identified from the clinical practices of 3 retina specialists. A subset of patients exhibiting annular RPE lesions on fundus autofluorescence was included for chart review and examination of multimodal imaging (study group). Patients with alternative etiologies for neurosensory detachment or pigment epitheliopathy were excluded. A second consecutive cohort of patients, with acute central serous chorioretinopathy, was also examined for the presence of annular lesions (comparative group).
Sixty-seven patients with chronic central serous chorioretinopathy were identified. Fourteen eyes of 12 patients exhibited annular lesions (study eyes). Mean visual acuity of study eyes was 20/27 (logMAR 0.13, SD 0.11). Annular lesions were composed of hyperautofluorescent stellate lesions arranged in an open or closed ring with intervening foci of punctate hypoautofluorescence. Optical coherence tomography showed RPE hyperplasia at the perimeters of annular lesions with loss of ellipsoid reflectivity and preserved RPE at the lesion center. Annular lesions were confined to the posterior poles and appeared to have developed at the margins of chronic neurosensory detachment. Forty-three eyes of 30 patients with acute central serous chorioretinopathy comprised the comparative group and none of these eyes exhibited annular lesions.
Annular lesions occur in up to a fifth of patients with chronic central serous chorioretinopathy but carry a relatively good visual prognosis. Curvilinear RPE figures and demarcation lines are seen in various retinal conditions but the characteristics of annular lesions described here suggest that they are specific to chronic central serous chorioretinopathy.
描述一系列在慢性中心性浆液性脉络膜视网膜病变背景下出现环形视网膜色素上皮（RPE）病变的患者。
回顾性比较病例系列。
从3位视网膜专科医生的临床实践中识别出连续的慢性中心性浆液性脉络膜视网膜病变患者。纳入在眼底自发荧光上表现出环形RPE病变的患者亚组进行病历回顾和多模态成像检查（研究组）。排除具有神经感觉性脱离或色素上皮病变其他病因的患者。还对连续的第二组急性中心性浆液性脉络膜视网膜病变患者进行环形病变检查（比较组）。
识别出67例慢性中心性浆液性脉络膜视网膜病变患者。12例患者的14只眼出现环形病变（研究眼）。研究眼的平均视力为20/27（logMAR 0.13，标准差0.11）。环形病变由排列成开放或闭合环的高自发荧光星芒状病变组成，其间有散在的点状低自发荧光灶。光学相干断层扫描显示环形病变周边的RPE增生，椭圆体反射率丧失，病变中心的RPE保留。环形病变局限于后极部，似乎在慢性神经感觉性脱离的边缘发展而来。30例急性中心性浆液性脉络膜视网膜病变患者的43只眼组成比较组，这些眼中均未出现环形病变。
环形病变在多达五分之一的慢性中心性浆液性脉络膜视网膜病变患者中出现，但视力预后相对较好。曲线状RPE图形和分界线在各种视网膜疾病中均可见，但此处描述的环形病变特征表明它们是慢性中心性浆液性脉络膜视网膜病变所特有的。
