Haimovici R, Gragoudas E S, Duker J S, Sjaarda R N, Eliott D
Boston University School of Medicine, Massachusetts 02114, USA.
Ophthalmology. 1997 Oct;104(10):1653-60. doi: 10.1016/s0161-6420(97)30082-7.
The purpose of the study is to investigate the relationship between inhaled or intranasal adrenergic agonists and corticosteroids and the development of central serous chorioretinopathy (CSC).
The medical records of three patients with CSC who were found to use inhaled adrenergic agents or corticosteroids or both were identified prospectively. A survey of members of the Retina, Macula, and Vitreous societies and the National Registry of Drug-Induced Ocular Side Effects identified three additional cases.
Six patients with CSC were found to be chronic users of corticosteroid (four patients) or both beta adrenergic agonist and corticosteroid (two patients) metered dose inhalers or nasal sprays. In three cases, there was a close temporal correlation between the use of a corticosteroid nasal spray and the development of CSC.
These findings suggest that, in patients who are susceptible, the periocular or systemic absorption of inhaled corticosteroids may be sufficient to produce CSC in humans, supporting previous hypotheses regarding the pathogenesis of the disorder. Further studies are needed to confirm this association and to determine whether inhaled adrenergic agents also contribute to the development of this disorder. Patients in whom CSC develops while using corticosteroid inhalers or nasal sprays should be alerted to the possible relationship between CSC and these agents.
本研究旨在调查吸入或鼻内使用肾上腺素能激动剂和皮质类固醇与中心性浆液性脉络膜视网膜病变（CSC）发生之间的关系。
前瞻性地识别出3例被发现使用吸入性肾上腺素能药物或皮质类固醇或两者的CSC患者的病历。对视网膜、黄斑和玻璃体协会成员以及药物性眼部副作用国家登记处进行调查，又发现了3例病例。
发现6例CSC患者长期使用皮质类固醇（4例患者）或同时使用β肾上腺素能激动剂和皮质类固醇（2例患者）的定量吸入器或鼻喷雾剂。在3例病例中，使用皮质类固醇鼻喷雾剂与CSC的发生之间存在密切的时间相关性。
这些发现表明，对于易感患者，吸入性皮质类固醇的眼周或全身吸收可能足以在人类中引发CSC，这支持了先前关于该疾病发病机制的假设。需要进一步研究来证实这种关联，并确定吸入性肾上腺素能药物是否也与该疾病的发生有关。对于在使用皮质类固醇吸入器或鼻喷雾剂时发生CSC的患者，应提醒他们注意CSC与这些药物之间可能存在的关系。
