Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.
Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Clin Exp Ophthalmol. 2023 Apr;51(3):243-270. doi: 10.1111/ceo.14201. Epub 2023 Jan 30.
Central serous chorioretinopathy (CSC) is the fourth most common non-surgical retinopathy associated with fluid leakage. The pathogenesis is not yet completely understood, but changes in the choroid, sclera and RPE have been described associated with venous congestion of choroidal outflow. CSC can be categorised into acute, chronic, and recurrent subtypes with recent classifications of simple and complex based on the area of RPE change seen on fundus autofluorescence. A multimodal imaging approach is helpful in the diagnosis and management of CSC and secondary complications such as type 1 neovascularisation. Although spontaneous resolution with relatively good visual outcomes is common, treatment should be considered in patients with persistent or recurrent SRF. Treatment options include laser, systemic medications, intravitreal therapy, and surgery. Of these, argon laser for focal extramacular fluid leaks and photodynamic therapy of leakage identified by indocyanine-green angiography currently have the greatest supportive evidence.
中心性浆液性脉络膜视网膜病变(CSC)是与液体渗漏相关的第四种最常见的非手术性视网膜病变。其发病机制尚未完全阐明,但已有研究描述了脉络膜、巩膜和 RPE 的变化与脉络膜流出静脉充血有关。CSC 可分为急性、慢性和复发性亚型,最近根据眼底自发荧光上 RPE 改变的面积进行了简单型和复杂型的分类。多模态成像方法有助于 CSC 的诊断和管理,以及继发于 CSC 的并发症,如 1 型新生血管。虽然自发缓解且视力结果相对较好较为常见,但对于持续性或复发性 SRF 患者,应考虑治疗。治疗选择包括激光、全身药物治疗、眼内治疗和手术。其中,氩激光治疗局灶性黄斑外液体渗漏和吲哚菁绿血管造影识别的渗漏的光动力疗法目前具有最大的支持证据。
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