Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France; and.
Centre d'Imagerie et Laser, Paris, France.
Retin Cases Brief Rep. 2023 May 1;17(3):288-293. doi: 10.1097/ICB.0000000000001170.
To describe central serous chorioretinopathy cases presenting as uveal effusion syndrome, providing new insights into "pachychoroid spectrum" diseases.
Clinical charts, color fundus photographs, fluorescein angiography, indocyanine green angiography, optical coherence tomography, ultrasound imaging, cerebral magnetic resonance imaging, and biometry of four eyes of three patients were assessed. A literature review was conducted.
The three patients had peripheral choroidal detachment and inferior bullous retinal detachment associated with central serous chorioretinopathy features detected using multimodal imaging, including fluorescein and indocyanine green angiography. The choroid was thick in the three patients, and uveal effusion occurred after steroid treatment in all cases. Subretinal fluid drainage and deep sclerectomy with flaps of 4 × 4 mm in both inferior quadrants were performed in three eyes of two patients with good outcomes. One patient was treated with photodynamic therapy. All three patients developed a typical leopard-spot pigmentary pattern in the fundus.
A severe presentation of highly exudative central serous chorioretinopathy may occur in rare cases with a peripheral choroidal detachment mimicking uveal effusion syndrome. These severe cases highlighted the role of choroidal thickening and hyperpermeability, choroidal vein dilation, and possible scleral thickening in both entities.
描述以葡萄膜渗漏综合征为表现的中心性浆液性脉络膜视网膜病变病例,为“厚脉络膜谱”疾病提供新的见解。
评估了三例四眼患者的临床病历、眼底彩照、荧光素血管造影、吲哚青绿血管造影、光学相干断层扫描、超声成像、脑部磁共振成像和生物测量。进行了文献复习。
三例患者均有周边脉络膜脱离和下大泡状视网膜脱离,伴有中心性浆液性脉络膜视网膜病变特征,采用多种模态成像技术,包括荧光素和吲哚青绿血管造影进行检测。三例患者的脉络膜均增厚,所有病例均在类固醇治疗后发生葡萄膜渗漏。两例患者的三只眼分别进行了视网膜下液引流和深层巩膜切除术(下方四个象限各做 4×4mm 的巩膜瓣),结果良好。一例患者接受了光动力疗法。所有三例患者眼底均出现典型的豹纹状色素图案。
在罕见情况下,可能会出现严重的高渗出性中心性浆液性脉络膜视网膜病变表现,伴有周边脉络膜脱离,类似于葡萄膜渗漏综合征。这些严重病例强调了脉络膜增厚和高通透性、脉络膜静脉扩张以及可能的巩膜增厚在这两种疾病中的作用。