Kornblau Ilyse S, Pritchett David Y, Wilson Matthew W
University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, Tennessee; and.
Veteran's Administration Medical Center, Department of Surgical Services, Division of Ophthalmology, Memphis, Tennessee.
Retin Cases Brief Rep. 2024 Nov 1;18(6):756-761. doi: 10.1097/ICB.0000000000001482.
The purpose of this study was to describe a case of supplemental testosterone-induced central serous chorioretinopathy (CSCR) mimicking a choroidal mass in a 63-year-old man.
This is a case report on a 63-year-old male patient on self-prescribed supplemental testosterone with CSCR mimicking a choroidal mass.
A 63-year-old man presented with new-onset vision loss, subretinal fluid, and choroidal mass in his left eye. IV fluorescein angiography showed an enhancing choroidal mass involving the fovea. B-scan ultrasonography revealed diffuse choroidal thickening. Given concern for a diffuse uveal melanoma, the lesion was biopsied showing nondiagnostic rare, atypical melanocytes. Four months after initial presentation, the patient was diagnosed with polycythemia vera. Fourteen months after diagnosis, he admitted to testosterone supplementation. On cessation of the testosterone supplement, the lesion progressively flattened to a chorioretinal scar with subretinal fluid resolution and returned to normal choroidal thickness over the next 14 months.
Testosterone supplementation has been linked to erythrocytosis and polycythemia vera. In the retina, testosterone supplementation has been linked to CSCR and both central and branch retinal artery and vein occlusions. This case report demonstrates the importance of inquiring about all prescribed and over-the-counter medications in patients presenting with retinal lesions of unknown origin.
本研究旨在描述一例63岁男性因补充睾酮诱发中心性浆液性脉络膜视网膜病变（CSCR），病变类似脉络膜肿物的病例。
这是一份关于一名63岁男性患者的病例报告，该患者自行服用补充睾酮药物，患有类似脉络膜肿物的CSCR。
一名63岁男性左眼出现新发视力丧失、视网膜下液和脉络膜肿物。静脉注射荧光素血管造影显示累及黄斑中心凹的脉络膜肿物有强化。B超检查显示脉络膜弥漫性增厚。鉴于怀疑为弥漫性葡萄膜黑色素瘤，对病变进行活检，结果显示有非诊断性的罕见非典型黑素细胞。初次就诊4个月后，该患者被诊断为真性红细胞增多症。确诊14个月后，他承认服用了补充睾酮药物。停用补充睾酮药物后，病变逐渐扁平，形成脉络膜视网膜瘢痕，视网膜下液消退，在接下来的14个月内脉络膜厚度恢复正常。
补充睾酮与红细胞增多症和真性红细胞增多症有关。在视网膜方面，补充睾酮与CSCR以及视网膜中央动脉和静脉阻塞及分支视网膜动脉和静脉阻塞有关。本病例报告表明，对于出现不明原因视网膜病变的患者，询问其所有处方药和非处方药的使用情况非常重要。
