Yu Jia, Li Lei, Jiang Chunhui, Chang Qing, Xu Gezhi
Department of Ophthalmology, Eye & Ear Nose Throat Hospital of Fudan University, Shanghai 200031, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China.
J Ophthalmol. 2021 Dec 16;2021:5580075. doi: 10.1155/2021/5580075. eCollection 2021.
To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population.
The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected.
Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100-20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50-20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone.
Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.
探讨中国人群妊娠相关性中心性浆液性脉络膜视网膜病变(CSC)的临床特征。
回顾性分析2012年2月至2019年10月诊断为妊娠相关性CSC患者的病历。收集最佳矫正视力(BCVA)、症状持续时间、妊娠相关医学信息及光学相干断层扫描(OCT)图像。
纳入9例患者(11只眼)。5例为初产妇,4例为经产妇,其中2例在首次妊娠时也发生过CSC。平均年龄为35.00±3.97岁。初诊时平均症状持续时间为19.73±13.65天。CSC发生时的平均孕周为27.11±2.09周。初诊时平均BCVA(最小分辨角对数(logMAR))为0.36±0.18(Snellen 20/45,范围20/100 - 20/25)。初诊时所有患眼OCT图像均显示视网膜下高反射性纤维蛋白。4例患者(4只眼)在视网膜下液吸收前失访。末次随访时平均BCVA为logMAR 0.10±0.15(Snellen 20/25,范围20/50 - 20/20)。最年长患者的1只眼在产后26个月仍有持续性视网膜下液。半剂量光动力疗法(PDT)后视网膜下液完全吸收;然而,半剂量PDT后30个月,黄斑区的椭圆体带仍不连续。其余6只眼在分娩前后均显示视网膜下液自发吸收,椭圆体带恢复完整。
中国妊娠相关性CSC多发生于孕晚期,通常在分娩前后自发恢复,最终视力良好。然而,患者可能需要长期随访,直至视网膜下液完全吸收并检测复发情况。如果产后视网膜下液量减少不明显,可早期给予半剂量PDT治疗。