LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous-Retina-Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York; Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia.
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous-Retina-Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York.
Ophthalmology. 2016 Jul;123(7):1541-52. doi: 10.1016/j.ophtha.2016.03.017. Epub 2016 Apr 12.
To define the phenotypic characteristics of the bullous variant of central serous chorioretinopathy (CSC) using multimethod imaging.
Retrospective, observational case series.
Twenty-one eyes of 14 patients with bullous retinal detachment resulting from CSC (bullous CSC group) and 122 eyes of 84 patients with chronic CSC without bullous retinal detachment (nonbullous CSC group).
We performed a retrospective review of clinical and multimethod imaging data of patients who sought treatment from the authors with bullous retinal detachment resulting from CSC between January 2010 and November 2015. Multimethod imaging comprised color photography, fluorescein angiography, fundus autofluorescence, and high-resolution optical coherence tomography. Consecutive cases of chronic CSC without bullous retinal detachment, seen during the same period, comprised a comparative group.
Qualitative and quantitative characteristics of the choroid, retinal pigment epithelium, and retina were compared between the 2 groups.
Mean age of the bullous CSC group was 53.8 years. There was no difference in age, visual acuity, corticosteroid use, or the proportion of white patients and men between the 2 groups (all P > 0.132). Peripheral nonperfusion occurred only in eyes with bullous retinal detachment (38% of cases). Retinal pigment epithelial tears were seen in 95% of eyes in the bullous group and none of the eyes in the nonbullous CSC group. The bullous CSC group demonstrated a greater number of pigment epithelial detachments (PEDs) and more eyes demonstrated PEDs with internal hyperreflectivity (both P < 0.016). Mean subfoveal choroidal thickness in the bullous CSC group (463.1±83.1 μm) was not different compared with that of the nonbullous CSC group (400.6±100.6 μm; P = 0.993). More eyes in the bullous CSC group demonstrated hyperreflectivity around large choroidal vessels and at the level of the choriocapillaris on OCT (P < 0.001). Retinal folds and subretinal fibrin were identified in a greater proportion of eyes in the bullous CSC group (both P < 0.001).
Bullous retinal detachment is a rare manifestation of chronic CSC and is characterized by a unique constellation of phenotypic and multimethod imaging features.
使用多模态成像技术定义中心性浆液性脉络膜视网膜病变（CSC）大疱型的表型特征。
回顾性观察性病例系列。
21 只眼来自 14 例大疱性视网膜脱离的 CSC 患者（大疱型 CSC 组），122 只眼来自 84 例无大疱性视网膜脱离的慢性 CSC 患者（非大疱型 CSC 组）。
我们对 2010 年 1 月至 2015 年 11 月间因 CSC 导致大疱性视网膜脱离而向作者寻求治疗的患者的临床和多模态成像数据进行回顾性分析。多模态成像包括彩色摄影、荧光素血管造影、眼底自发荧光和高分辨率光学相干断层扫描。同时期观察到的连续慢性 CSC 无大疱性视网膜脱离病例为对照组。
比较两组脉络膜、视网膜色素上皮和视网膜的定性和定量特征。
大疱型 CSC 组的平均年龄为 53.8 岁。两组在年龄、视力、皮质类固醇使用、白种人比例和男性比例方面均无差异（均 P > 0.132）。仅在大疱性视网膜脱离的眼中观察到周边无灌注（38%的病例）。大疱型组 95%的眼中可见视网膜色素上皮撕裂，而非大疱型 CSC 组无一例。大疱型 CSC 组的 PED 数量更多，且更多的眼内 PED 表现为内部高反射（均 P < 0.016）。大疱型 CSC 组的黄斑中心凹下脉络膜厚度（463.1±83.1μm）与非大疱型 CSC 组（400.6±100.6μm；P=0.993）无差异。大疱型 CSC 组 OCT 检查中较大脉络膜血管周围和脉络膜毛细血管层水平可见更多高反射（均 P < 0.001）。大疱型 CSC 组中更多的眼中可见视网膜褶皱和视网膜下纤维蛋白（均 P < 0.001）。
大疱性视网膜脱离是慢性 CSC 的一种罕见表现，其特征为独特的表型和多模态成像特征组合。
