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患者特征和中心性浆液性脉络膜视网膜病变的危险因素:811 例患者分析。

Patient characteristics and risk factors for central serous chorioretinopathy: an analysis of 811 patients.

机构信息

Istanbul Retina Institute, Istanbul, Turkey.

Istanbul Retina Institute, Istanbul, Turkey

出版信息

Br J Ophthalmol. 2019 Jun;103(6):725-729. doi: 10.1136/bjophthalmol-2018-312431. Epub 2018 Jul 12.

Abstract

AIMS

To determine the demographic and morphological characteristics of patients with central serous chorioretinopathy (CSC) and describe risk factors for CSC.

METHODS

We retrospectively reviewed medical records of 811 patients with CSC and 816 healthy controls referred from 2002 to 2018.

RESULTS

The female/male ratio of patients with CSC was 1/2.7. Mean age of onset was 45.2 years. The peak prevalence for men occurred at 45-49 years. Women had two prevalence peaks, the higher at 55-59 years and the other at 45-49 years. Of these patients, 56.8% had unilateral disease, 42.1% had bilateral disease and 1.1% had only one eye. 671 (82.7%) patients had spectral domain optical coherence tomography (SD-OCT) images and 598 (73.7%) had enhanced depth choroidal images. Pigment epithelial detachment (PED) was detected in 763 (80.7%) of 945 eyes with SD-OCT images. Chronic cases were more likely to be bilateral and multifocal and to have PED (all p<0.001). Subfoveal choroidal thickness (SFCT) did not differ between chronic and classic cases (p=0.74), but SFCT was greater in multifocal cases than unifocal cases (p<0.001). In multivariate regression analyses, older age of onset, longer duration of disease and hyperopia were positively associated with having chronic disease rather than classic disease, and myopia and thyroid hormone replacement were negatively associated. Steroid use, antidepressant or anxiolytic drug use, smoking, pregnancy and hyperopia were risk factors, and myopia was a protective factor for CSC.

CONCLUSION

This is the largest case-control study of CSC to evaluate demographic morphological characteristics and risk factors. Multiple factors are associated with CSC.

摘要

目的

确定中心性浆液性脉络膜视网膜病变(CSC)患者的人口统计学和形态学特征,并描述 CSC 的危险因素。

方法

我们回顾性分析了 2002 年至 2018 年间就诊的 811 例 CSC 患者和 816 例健康对照者的病历。

结果

CSC 患者中女性与男性的比例为 1∶2.7。发病年龄的平均值为 45.2 岁。男性的发病高峰在 45-49 岁,女性有两个发病高峰,较高的一个在 55-59 岁,另一个在 45-49 岁。这些患者中,56.8%为单侧疾病,42.1%为双侧疾病,1.1%为单眼疾病。671 例(82.7%)患者有谱域光学相干断层扫描(SD-OCT)图像,598 例(73.7%)有增强深度脉络膜图像。在有 SD-OCT 图像的 945 只眼中,763 只(80.7%)检测到色素上皮脱离(PED)。慢性病例更可能为双侧、多灶性,并伴有 PED(均 P<0.001)。慢性与经典病例的中心凹下脉络膜厚度(SFCT)无差异(P=0.74),但多灶性病例的 SFCT 大于单灶性病例(P<0.001)。在多变量回归分析中,发病年龄较大、疾病持续时间较长和远视与患慢性疾病而非经典疾病呈正相关,近视和甲状腺激素替代治疗与患慢性疾病而非经典疾病呈负相关。使用类固醇、抗抑郁或抗焦虑药物、吸烟、妊娠和远视是 CSC 的危险因素,而近视是 CSC 的保护因素。

结论

这是最大的 CSC 病例对照研究,评估了人口统计学和形态学特征以及危险因素。多种因素与 CSC 相关。

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