Pang Bing, Ni Qing, Wang Ya-Jing, Ba Jian-Ming, Ni Qi, Chen Kang
Department of Endocrinology, The First Medical Center of the People's Liberation Army General Hospital, Beijing 100853, China.
Department of Endocrinology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing 100054, China.
JCEM Case Rep. 2025 Sep 12;3(10):luaf196. doi: 10.1210/jcemcr/luaf196. eCollection 2025 Oct.
This study aimed to elucidate the potential relationship between central serous chorioretinopathy (CSC) and both endogenous hypercortisolism and the administration of exogenous corticosteroids. Case 1 involved a 39-year-old female patient who presented with blurred vision and metamorphopsia. Ophthalmologic examinations confirmed bilateral CSC. Biochemical and clinical evidence suggested hypercortisolism, and abdominal computed tomography revealed an adrenal adenoma, leading to a diagnosis of adrenocorticotropin-independent Cushing syndrome (CS). Postoperatively, a regression of serous retinal detachments was observed within 6 weeks. Case 2 referred to a 60-year-old male patient with hyperthyroidism and Graves orbitopathy who experienced vision loss after intravenous administration of 4.5 g of methylprednisolone over 10 weeks. Vision deteriorated after glucocorticoid therapy but improved 6 months later on discontinuation. Subsequently, the patient received peribulbar injections of triamcinolone acetonide, resulting in acute vision loss, with ophthalmologic examinations confirming CSC. After the cessation of exogenous corticosteroids, CSC resolved, and retinal pigment epithelium detachment also resolved at 3 months. Although causality cannot be definitively established with only 2 cases, the spontaneous resolution of subretinal fluid following corticosteroid withdrawal is highly indicative. The use of both endogenous hypercortisolism and exogenous corticosteroids is implicated as a risk factor for CSC, warranting increased vigilance from endocrinologists.
本研究旨在阐明中心性浆液性脉络膜视网膜病变(CSC)与内源性皮质醇增多症及外源性皮质类固醇激素给药之间的潜在关系。病例1为一名39岁女性患者,表现为视力模糊和视物变形。眼科检查确诊为双侧CSC。生化和临床证据提示皮质醇增多症,腹部计算机断层扫描显示肾上腺腺瘤,诊断为促肾上腺皮质激素非依赖性库欣综合征(CS)。术后6周内观察到浆液性视网膜脱离消退。病例2为一名60岁男性患者,患有甲状腺功能亢进症和格雷夫斯眼眶病,在10周内静脉注射4.5 g甲泼尼龙后出现视力丧失。糖皮质激素治疗后视力恶化,但停药6个月后改善。随后,患者接受球周注射曲安奈德,导致急性视力丧失,眼科检查确诊为CSC。停用外源性皮质类固醇激素后,CSC消退,视网膜色素上皮脱离在3个月时也消退。虽然仅2例病例无法明确确定因果关系,但皮质类固醇激素停药后视网膜下液的自发消退具有高度指示性。内源性皮质醇增多症和外源性皮质类固醇激素的使用均被认为是CSC的危险因素,内分泌科医生应提高警惕。