Apel Warren, Li Ye
Department of Ophthalmology, Sunshine Coast University Hospital, QLD, Australia.
J Vitreoretin Dis. 2025 Apr 25:24741264251337104. doi: 10.1177/24741264251337104.
To report a case of bullous central serous chorioretinopathy (CSCR) after starting a Janus kinase (JAK) inhibitor and describe the results of focal laser treatment. A single case was evaluated. A 54-year-old man with rheumatoid arthritis presented with a 2-week history of left superior field loss. His medications included prednisone 10 mg and upadacitinib, which was added to his regimen 3 weeks previously. His visual acuity (VA) was 20/25 OD and 20/30 OS. An ophthalmic examination of the left eye found an ill-defined white lesion of 2 × 3 disc diameters at the macula with an inferior retinal detachment (RD). Optical coherence tomography showed subretinal fibrin with subretinal fluid (SRF) and a pigment epithelial detachment. After a diagnosis of bullous CSCR was made, focal laser application was performed. One year later, the patient's VA recovered to 20/20 with resolved SRF. Bullous CSCR with a serous RD is an uncommon subtype of pachychoroid disease. Upadacitinib may be associated with its occurrence through disequilibrium of the coagulation cascade. Focal laser treatment offers a favorable outcome for this disease.
报告一例在开始使用Janus激酶（JAK）抑制剂后发生的大疱性中心性浆液性脉络膜视网膜病变（CSCR）病例，并描述局灶性激光治疗的结果。评估了一例病例。一名54岁的类风湿性关节炎男性患者，有2周的左上视野缺损病史。他的药物包括泼尼松10mg和乌帕替尼，3周前开始使用该药物。他的视力（VA）右眼为20/25，左眼为20/30。左眼眼科检查发现黄斑区有一个边界不清的白色病变，大小为2×3视盘直径，伴有下方视网膜脱离（RD）。光学相干断层扫描显示视网膜下有纤维蛋白和视网膜下液（SRF）以及色素上皮脱离。在诊断为大疱性CSCR后，进行了局灶性激光治疗。一年后，患者的视力恢复到20/20，视网膜下液消退。伴有浆液性视网膜脱离的大疱性CSCR是厚脉络膜疾病的一种罕见亚型。乌帕替尼可能通过凝血级联失衡与其发生相关。局灶性激光治疗对这种疾病有良好的疗效。
