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两对夫妻患中心性浆液性脉络膜视网膜病变的病例报告

PRESENTATION OF CENTRAL SEROUS CHORIORETINOPATHY IN TWO HUSBAND AND WIFE COUPLES.

作者信息

Kanesa-Thasan Aditya, Fawzi Amani A, Gill Manjot K

机构信息

Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

Retin Cases Brief Rep. 2018;12(2):100-102. doi: 10.1097/ICB.0000000000000452.

Abstract

PURPOSE

Central serous chorioretinopathy (CSC) is a disease in which serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium. Associations have been drawn between high-stress personality types and steroid exposure. This article aims to describe a unique case series of two husband and wife couples with CSC.

METHODS

All methods were approved by the authors' institution's institutional review board. History, physical examination, and imaging data were obtained from the electronic medical records of the patients in question and from the providers who cared for these patients.

RESULTS

Couple 1: A 35-year-old man presented with "dark spots" in his right eye. He reported no recent steroid use. Visual acuity at presentation was 20/30 in the right eye and 20/20 in the left eye. On fundus examination, there was subretinal fluid in the right eye. His wife presented on the same day with a "wavy section" in the right eye for 6 weeks. She also had no recent steroid use. Visual acuity at presentation was 20/20 in both eyes with blunting of the foveal reflex in the right eye. Optical coherence tomography showed a thick choroid with a pigment epithelial detachment in the right eye. Couple 2: A 34-year-old man presented with "blurry vision" in his right eye for one month. He was taking oral and nasal steroids for chronic sinusitis. Visual acuity was 20/30 in the right eye and 20/20 in the left eye. Fluorescein angiography and indocyanine green confirmed the diagnosis of CSC. After 3 months of persistent subretinal fluid, he received photodynamic therapy in the right eye. Three days after his photodynamic therapy, his 38-year-old wife presented with subjective blurring in both eyes. Visual acuity was 20/20 in both eyes, but optical coherence tomography showed thick choroid in both eyes, a large central pigment epithelial detachment in the right eye, and 3 small pigment epithelial detachments in the left eye. She had no history of steroid use but did admit to high stress recently.

CONCLUSION

All the patients in this case series were diagnosed with CSC. This is the first series to describe the simultaneous occurrence of CSC in spouses. Possible explanations for these presentations may include shared external stressors or secondary steroid exposure. Clinicians may consider inquiring about family members or cohabitants with similar symptoms if CSC is suspected.

摘要

目的

中心性浆液性脉络膜视网膜病变(CSC)是一种神经感觉视网膜浆液性脱离发生于脉络膜毛细血管通过视网膜色素上皮渗漏区域的疾病。高压力人格类型与类固醇暴露之间已建立关联。本文旨在描述一个独特的病例系列,其中两对夫妻均患有CSC。

方法

所有方法均经作者所在机构的机构审查委员会批准。病史、体格检查和影像学数据来自相关患者的电子病历以及照料这些患者的医疗服务提供者。

结果

第一对夫妻:一名35岁男性因右眼出现“黑点”前来就诊。他报告近期未使用类固醇。就诊时右眼视力为20/30,左眼视力为20/20。眼底检查发现右眼有视网膜下液。他的妻子同一天因右眼出现“波浪状区域”6周前来就诊。她近期也未使用类固醇。就诊时双眼视力均为20/20,但右眼黄斑反射迟钝。光学相干断层扫描显示右眼脉络膜增厚伴色素上皮脱离。第二对夫妻:一名34岁男性因右眼“视力模糊”1个月前来就诊。他因慢性鼻窦炎正在服用口服和鼻用类固醇。右眼视力为20/30,左眼视力为20/20。荧光素血管造影和吲哚菁绿造影确诊为CSC。在视网膜下液持续3个月后,他右眼接受了光动力疗法。光动力疗法3天后,他38岁的妻子出现双眼主观视力模糊。双眼视力均为20/20,但光学相干断层扫描显示双眼脉络膜增厚,右眼有一个大的中心色素上皮脱离,左眼有3个小的色素上皮脱离。她无类固醇使用史,但承认近期压力较大。

结论

该病例系列中的所有患者均被诊断为CSC。这是首个描述配偶同时发生CSC的系列病例。这些表现的可能解释包括共同的外部压力源或继发性类固醇暴露。如果怀疑患有CSC,临床医生可能会考虑询问有类似症状的家庭成员或同居者。

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