Kim Yong Kyu, Woo Se Joon, Park Kyu Hyung, Chi Yeon Kyung, Han Ji Won, Kim Ki Woong
Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2018 Aug;32(4):281-289. doi: 10.3341/kjo.2017.0144.
To analyze the psychosocial factors associated with central serous chorioretinopathy (CSC) according to its phases and subtypes and to correlate the factors with the extent of choroidal hyperpermeability.
Age- and sex-matched CSC patients and controls (n = 37 in each group) were enrolled, and their psychosocial factors were compared. CSC was divided into two phases (active and inactive), and active CSC was further divided into two subtypes (acute and chronic). The correlations between the size of the hyperpermeable choroidal lesion identified on indocyanine green angiography and psychosocial factors were examined.
Active CSC patients experienced more stressful events (p = 0.030), were more depressive (p = 0.037), and felt less emotional (p = 0.014) and informational (p = 0.014) support than the matched controls, whereas inactive CSC patients were comparable to the matched controls in all psychosocial factors. Among the active CSC patients, acute patients were more depressive (p = 0.029), while chronic patients experienced more stressful events (p = 0.024) than their matched controls. The size of the hyperpermeable choroidal lesion was correlated with the severity of depression in acute patients.
Association of CSC with psychosocial factors was dependent on the phase and subtype of CSC. Psychosocial factors were associated with CSC in the active phase, and severity of depression was correlated with the size of the choroidal pathology in acute active CSC. Further prospective studies to investigate if psychosocial factors can trigger CSC are warranted.
根据中心性浆液性脉络膜视网膜病变（CSC）的阶段和亚型分析与之相关的社会心理因素，并将这些因素与脉络膜高通透性的程度进行关联。
纳入年龄和性别匹配的CSC患者和对照组（每组37例），比较他们的社会心理因素。CSC分为两个阶段（活动期和非活动期），活动期CSC进一步分为两个亚型（急性和慢性）。研究吲哚青绿血管造影显示的脉络膜高通透性病变大小与社会心理因素之间的相关性。
与匹配的对照组相比，活动期CSC患者经历更多应激事件（p = 0.030），更易抑郁（p = 0.037），且感觉情感支持（p = 0.014）和信息支持（p = 0.014）更少，而非活动期CSC患者在所有社会心理因素方面与匹配的对照组相当。在活动期CSC患者中，急性患者更易抑郁（p = 0.029），而慢性患者经历更多应激事件（p = 0.024）。急性患者中，脉络膜高通透性病变大小与抑郁严重程度相关。
CSC与社会心理因素的关联取决于CSC的阶段和亚型。社会心理因素与活动期CSC相关，急性活动期CSC中抑郁严重程度与脉络膜病变大小相关。有必要进行进一步的前瞻性研究，以调查社会心理因素是否会引发CSC。
