Breukink Myrte B, Dingemans Alexander Jm, den Hollander Anneke I, Keunen Jan Ee, MacLaren Robert E, Fauser Sascha, Querques Giuseppe, Hoyng Carel B, Downes Susan M, Boon Camiel Jf
Department of Ophthalmology.
Department of Ophthalmology; Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
Clin Ophthalmol. 2016 Dec 20;11:39-46. doi: 10.2147/OPTH.S115685. eCollection 2017.
To describe the clinical findings and long-term outcome of patients with chronic central serous chorioretinopathy (cCSC).
This was a retrospective case series in 52 eyes of 36 patients with a follow-up period of at least 1 year. Extensive ophthalmic examination and a validated questionnaire concerning vision-related quality of life (National Eye Institute Visual Function Questionnaire [NEI-VFQ]-39) were analyzed.
Mean visual acuity showed a significant decline over time of 0.16 logarithm of minimum angle of resolution ([logMAR] range: -0.22 to 1.3; =0.009) after a mean follow-up period of 10.6 years. Also, patients reported lower vision-related quality of life based on the NEI-VFQ-39 for almost all categories compared to healthy controls. Macular atrophy was diagnosed more often on optical coherence tomography compared to other diagnostic entities. Retinal pigment epithelium detachments in the macula were documented on optical coherence tomography in 56% of the patients. A significant thinning of foveal thickness was measured over time compared to unaffected fellow eyes (=0.002). On long-term follow-up, 13 eyes (37%) showed an increase in number of hot spots on fluorescein angiography.
This study indicates that cCSC is a progressive disease in many patients, causing a progressive decline in visual acuity, accompanied by lower reported vision-related quality of life. In deciding whether or not to treat, the progressive nature of cCSC should be taken into account in this relatively young and often still professionally active patient group.
描述慢性中心性浆液性脉络膜视网膜病变（cCSC）患者的临床特征及长期预后。
这是一项回顾性病例系列研究，纳入36例患者的52只眼，随访期至少1年。分析了全面的眼科检查结果以及一份关于视力相关生活质量的有效问卷（美国国立眼科研究所视觉功能问卷[NEI-VFQ]-39）。
平均随访10.6年后，平均视力随时间显著下降，最小分辨角对数（[logMAR]范围：-0.22至1.3；P=0.009）下降了0.16。此外，与健康对照相比，几乎所有类别中，患者基于NEI-VFQ-39报告的视力相关生活质量较低。与其他诊断实体相比，光学相干断层扫描更常诊断出黄斑萎缩。56%的患者在光学相干断层扫描中记录到黄斑区视网膜色素上皮脱离。与未受影响的对侧眼相比，随时间测量到黄斑中心凹厚度显著变薄（P=0.002）。长期随访中，13只眼（37%）在荧光素血管造影中显示热点数量增加。
本研究表明，cCSC在许多患者中是一种进行性疾病，导致视力逐渐下降，同时报告的视力相关生活质量较低。在决定是否治疗时，对于这个相对年轻且通常仍在职业上活跃的患者群体，应考虑cCSC的进行性本质。
