Ophthalmology Department, Centro Hospitalar Universitário de São João, E.P.E., Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
Faculty of Medicine of University of Porto, Porto, Portugal.
BMC Ophthalmol. 2022 Sep 5;22(1):359. doi: 10.1186/s12886-022-02566-w.
To report an unusual case of central serous chorioretinopathy in a patient with angioid streaks.
The authors describe a case report of a 26-year old male patient presenting acute scotoma and metamorphopsia in OD. He had been diagnosed with angioid streaks complicated with choroidal neovascularization and referred to us for treatment. The patient presented an ETDRS score of 85 letters (20/20) in OD and in OS. The anterior segment examination was unremarkable. Fundoscopy revealed bilateral angioid streaks (AS) and peau d'orange, as well as a small neurosensory retinal detachment in the macula of OD. A multimodal retinal analysis, including fundus photography, infra-red and fundus autofluorescence imaging, spectral-domain optical coherence tomography, optical coherence tomography angiography, fluorescein and indocyanine green angiography was performed. The diagnosis of central serous chorioretinopathy was made in the absence of any identifiable choroidal neovascularization. He was submitted to half-dose photodynamic therapy with verteporfin. One month later, he reported no visual complaints, his vision was 85 letters (20/20) in OD and a complete resolution of the sub-retinal fluid was registered. No signs of choroidal neovascularization were detected on the optical coherence tomography angiography (OCTA). A complete medical workup evaluation was made to exclude systemic diseases usually associated with AS.
To the authors' knowledge, this is the second reported case of CSC associated with angioid streaks. The focal abnormalities in the Bruch's membrane and the irregular vascular choriocapillary network associated with AS might predispose to CSC.
报告一例伴有脉络膜血管样条纹的中心性浆液性脉络膜视网膜病变的罕见病例。
作者描述了一例 26 岁男性患者的病例报告，其右眼出现急性盲点和变形。该患者曾被诊断为伴有脉络膜新生血管的脉络膜血管样条纹，并转诊至我们处接受治疗。患者在右眼的 ETDRS 评分中表现出 85 个字母（20/20），而在左眼则表现出 20/25 的视力。眼前节检查未见明显异常。眼底镜检查显示双眼均有脉络膜血管样条纹（AS）和橘皮样外观，以及右眼黄斑区的小神经感觉性视网膜脱离。进行了包括眼底照相、近红外和眼底自发荧光成像、频域光学相干断层扫描、光相干断层扫描血管造影、荧光素和吲哚青绿血管造影在内的多模态视网膜分析。在没有任何可识别的脉络膜新生血管的情况下，作出了中心性浆液性脉络膜视网膜病变的诊断。他接受了半剂量光动力疗法治疗维替泊芬。一个月后，他报告没有视力问题，右眼视力为 85 个字母（20/20），并记录到视网膜下液完全消退。光相干断层扫描血管造影（OCTA）未发现脉络膜新生血管的迹象。进行了全面的医学评估，以排除通常与 AS 相关的系统性疾病。
据作者所知，这是第二例与脉络膜血管样条纹相关的 CSC 报告。脉络膜血管样条纹中布鲁赫膜的局灶性异常和不规则的血管脉络膜毛细血管网络可能使患者易患 CSC。
