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中心性浆液性脉络膜视网膜病变:治疗现状的最新进展

Central Serous Chorioretinopathy: An Update on the Current State of Management.

作者信息

Kalogeropoulos Dimitrios, Shaw Lincoln, Skondra Dimitra, Ch'ng Soon Wai, Christodoulou Aikaterini, Kalogeropoulos Chris

机构信息

Ophthalmology, University General Hospital of Ioannina, Ioannina, Greece.

Ophthalmology, University of Chicago, Pritzker School of Medicine, Chicago, Illinois, United States.

出版信息

Klin Monbl Augenheilkd. 2024 Jul;241(7):845-862. doi: 10.1055/a-2062-3751. Epub 2023 Jun 19.

Abstract

Central serous chorioretinopathy (CSCR) is a relatively common retinal disorder that leads to central vision impairment, often with a high recurrence rate. The exact etiology and pathogenetic mechanisms have not been fully elucidated but are likely to be associated with hyperpermeability of the choroidal capillaries and failure of the retinal pigment epithelium (RPE), leading to serous detachment of the neurosensory retina. Multimodal imaging plays a critical role in the diagnostic approach and monitoring of CSCR. Fortunately, the natural course of the disease is usually self-limiting, with spontaneous resolution and total fluid reabsorption. However, some patients may exhibit recurrences or persistent subretinal fluid (chronic CSCR), leading to progressive and irreversible RPE atrophy or photoreceptor damage. Thus, to prevent permanent visual loss, individualized treatment should be considered. Recent developments in the diagnostic and therapeutic approach have contributed to better outcomes in patients with CSCR. More studies are required to improve our understanding of epidemiology, pathogenesis, diagnosis, and treatment, with a significant impact on the management of this challenging clinical entity. The purpose of this review is to summarize the current knowledge about the clinical features, diagnostic workup, and therapeutic approach of CSCR.

摘要

中心性浆液性脉络膜视网膜病变(CSCR)是一种相对常见的视网膜疾病,可导致中心视力受损,且复发率通常较高。确切的病因和发病机制尚未完全阐明,但可能与脉络膜毛细血管的高通透性以及视网膜色素上皮(RPE)功能障碍有关,进而导致神经感觉视网膜的浆液性脱离。多模态成像在CSCR的诊断和监测中起着关键作用。幸运的是,该病的自然病程通常具有自限性,可自发消退且液体完全吸收。然而,一些患者可能会复发或出现持续性视网膜下液(慢性CSCR),导致进行性且不可逆的RPE萎缩或光感受器损伤。因此,为防止永久性视力丧失,应考虑个体化治疗。诊断和治疗方法的最新进展已使CSCR患者获得了更好的治疗效果。需要更多研究来增进我们对其流行病学、发病机制、诊断和治疗的理解,这将对这一具有挑战性的临床疾病的管理产生重大影响。本综述的目的是总结目前关于CSCR临床特征、诊断检查和治疗方法的知识。

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