单纯性与复杂性中心性浆液性脉络膜视网膜病变的不同特征

DISTINCT CHARACTERISTICS OF SIMPLE VERSUS COMPLEX CENTRAL SEROUS CHORIORETINOPATHY.

作者信息

Yoneyama Seigo, Fukui Ayumi, Sakurada Yoichi, Terao Nobuhiro, Shijo Taiyo, Kusada Natsuki, Sugiyama Atsushi, Matsubara Mio, Fukuda Yoshiko, Kikushima Wataru, Mabuchi Fumihiko, Sotozono Chie, Kashiwagi Kenji

机构信息

Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and.

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto Kyoto, Japan.

出版信息

Retina. 2023 Mar 1;43(3):389-395. doi: 10.1097/IAE.0000000000003692.

DOI:10.1097/IAE.0000000000003692

PMID:36729824

Abstract

PURPOSE

To compare the clinical and genetic characteristics of simple and complex central serous chorioretinopathy using central serous chorioretinopathy international group criteria.

METHODS

Patients with idiopathic central serous chorioretinopathy were included. Depending on the presence or absence of retinal pigment alterations greater than 2-disc areas in either eye, patients were classified into complex or simple types. Demographic factors and clinical findings were compared between groups. CFH variants, including rs800292 and rs1329428, were genotyped using TaqMan technology.

RESULTS

A total of 319 consecutive patients were evaluated at the initial presentation. Of them, 53 (16.6%) had the complex type. The complex type was exclusively seen in men (100% vs. 79.0%, P = 2.0 × 10 -4 ) and demonstrated a significantly higher proportion of bilateral involvement (75.5% vs. 17.7%, P = 6.2 × 10 -18 ) and descending tract(s) (83.0% vs. 0%, P = 1.2 × 10 -57 ) than the simple type. Increased choroidal thickness (425 ± 131 vs. 382 ± 110, P = 0.02) and decreased central retinal thickness (274 ± 151 vs. 337 ± 136, P = 2.9 × 10 -4 ) were observed for the complex versus simple type. The risk allele frequencies of both variants were significantly higher in the complex versus simple type (rs800292: 61.3% vs. 48.7%, P = 0.018; rs1329428: 65.1% vs. 54.3%, P = 0.04).

CONCLUSION

In this new classification system, the complex type has distinct genetic and clinical characteristics compared with the simple type.

摘要

目的

使用中心性浆液性脉络膜视网膜病变国际研究组标准，比较单纯型和复杂型中心性浆液性脉络膜视网膜病变的临床和遗传特征。

方法

纳入特发性中心性浆液性脉络膜视网膜病变患者。根据任一眼视网膜色素改变面积是否大于2个视盘面积，将患者分为复杂型或单纯型。比较两组间的人口统计学因素和临床特征。使用TaqMan技术对CFH基因变异（包括rs800292和rs1329428）进行基因分型。

结果

共有319例连续患者在初次就诊时接受评估。其中，53例（16.6%）为复杂型。复杂型仅见于男性（100%对79.0%，P = 2.0×10⁻⁴），与单纯型相比，双侧受累比例（75.5%对17.7%，P = 6.2×10⁻¹⁸）和存在下降支（83.0%对0%，P = 1.2×10⁻⁵⁷）显著更高。与单纯型相比，复杂型脉络膜厚度增加（425±131对382±110，P = 0.02），中心视网膜厚度降低（274±151对337±136，P = 2.9×10⁻⁴）。复杂型与单纯型相比，两种变异的风险等位基因频率均显著更高（rs800292：61.3%对48.7%，P = 0.018；rs1329428：65.1%对54.3%，P = 0.04）。