Gawęcki Maciej, Grzybowski Andrzej, Pompein-Batkiewicz Monika
Dobry Wzrok Ophthalmological Clinic, Gdansk, Poland.
Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.
Case Rep Ophthalmol. 2022 Sep 19;13(3):678-685. doi: 10.1159/000525924. eCollection 2022 Fall.
A 37-year-old man experienced two episodes of central serous chorioretinopathy (CSCR) with the onset within a 7-month period, one in each eye. The diagnosis was made based on spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), and fluorescein angiography. The presence of subretinal neovascularization and polypoidal choroidal vasculopathy were excluded. Each CSCR episode lasted for approximately 6 months and resolved completely after laser photocoagulation (left eye) and photodynamic therapy (right eye). In the right eye, subthreshold micropulse laser treatment and oral eplerenone were initially administered because of a verteporfin shortage, but they were not effective. Final best-corrected visual acuity was 0.8 logMAR in the left eye and "counting fingers" in the right. SD-OCT revealed significant retinal thinning in both eyes despite FAF, showing no major loss of retinal pigment epithelial cells. A significant reduction of ganglion cell complex thickness occurred in the right eye. Acute CSCR can result in significant visual impairment, even when short-lasting.
一名37岁男性在7个月内双眼先后各发作一次中心性浆液性脉络膜视网膜病变（CSCR）。诊断基于频域光学相干断层扫描（SD - OCT）、眼底自发荧光（FAF）和荧光素血管造影。排除了视网膜下新生血管形成和息肉样脉络膜血管病变。每次CSCR发作持续约6个月，经激光光凝治疗（左眼）和光动力疗法（右眼）后完全消退。右眼因维替泊芬短缺，最初给予阈下微脉冲激光治疗和口服依普利酮，但无效。最终左眼最佳矫正视力为0.8 logMAR，右眼为“数指”。尽管FAF显示视网膜色素上皮细胞无重大损失，但SD - OCT显示双眼视网膜显著变薄。右眼神经节细胞复合体厚度显著降低。急性CSCR即使持续时间短也可导致显著视力损害。
