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中心性浆液性脉络膜视网膜病变综述:临床表现与治疗

A Review of Central Serous Chorioretinopathy: Clinical Presentation and Management.

作者信息

Varghese Jerin, Kesharwani Dipanshu, Parashar Shreya, Agrawal Prerna

机构信息

Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Aug 13;14(8):e27965. doi: 10.7759/cureus.27965. eCollection 2022 Aug.

Abstract

Central serous chorioretinopathy (CSC) may be understood as a disease of the chorioretina with the serous detachment of the neurosensory retina, which is secondary to single or multiple localized defects in retinal pigment epithelium (RPE). CSC is one of the common forms of loss of vision, usually seen in people who do belong to the working-age group. The most common symptoms are blurring of vision, usually unilateral and which is perceived as a scotoma in the center of the field of vision with associated metamorphopsia and micropsia. The risk factor associated with CSC is psychosocial stress, type A personality, pregnancy, and hypercortisolism. Normal vision is often restored within a span of a few months. After around three months, if the resolution of acute CSC did not change or, let us say, in the case of CSC that is chronic, one should consider treatment. In acute CSC, to resolve symptoms, especially in individuals who work in a field where eyesight is of utmost importance, for example, pilots, focal photocoagulation of leaking RPE lesions can be performed. CSC is a prototype cause of serous neuroretinal detachment, which involves the fovea. CSC symptoms reflect the separation between the RPE and the photoreceptors and the bullous distension of the foveal retina. The effect of therapy as such on the long-term outcome of vision visual is not sufficiently documented. The management would largely be dependent on the appropriate diagnosis made based on clinical presentations, and thus it becomes very much necessary to have knowledge about the same and counsel the patient regarding the association between stress and disease pathology. In acute CSC, retinal photocoagulation is successful to a good extent in eliminating or reducing the leakage of RPE and hence it induces resolution of the serous detachment. This review article is made to make sure the reader is updated about the various clinical and management aspects of CSC by providing a comprehensive idea that is obtained from various well-acknowledged databases across the globe on CSC.

摘要

中心性浆液性脉络膜视网膜病变(CSC)可被理解为一种脉络膜视网膜疾病,其神经感觉视网膜发生浆液性脱离,继发于视网膜色素上皮(RPE)的单个或多个局部缺陷。CSC是常见的视力丧失形式之一,通常见于处于工作年龄组的人群。最常见的症状是视力模糊,通常为单侧,表现为视野中心的暗点,并伴有视物变形和小视症。与CSC相关的危险因素包括心理社会压力、A型人格、妊娠和高皮质醇血症。正常视力通常在几个月内恢复。大约三个月后,如果急性CSC的病情没有改善,或者在慢性CSC的情况下,就应该考虑进行治疗。在急性CSC中,为缓解症状,特别是对于从事视力至关重要工作的人群,如飞行员,可对渗漏的RPE病变进行局部光凝治疗。CSC是累及黄斑的浆液性神经视网膜脱离的典型病因。CSC的症状反映了RPE与光感受器之间的分离以及黄斑视网膜的大疱性扩张。目前关于此类治疗对视力长期预后的影响尚无充分记录。治疗很大程度上取决于基于临床表现做出的正确诊断,因此了解相关知识并就压力与疾病病理之间的关联对患者进行咨询非常必要。在急性CSC中,视网膜光凝在很大程度上成功消除或减少了RPE的渗漏,从而促使浆液性脱离消退。这篇综述文章旨在通过提供从全球各种知名数据库中获取的关于CSC的全面信息,确保读者了解CSC的各种临床和治疗方面的最新情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d18/9467487/cf4e797b3759/cureus-0014-00000027965-i01.jpg

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