Abstract:
Central serous chorioretinopathy (CSC) is a disease characterized by serous detachment of the neuroretina, especially in the posterior pole of the eye. It is often accompanied by serous detachment of the retinal pigment epithelium (RPE) and associated with the leakage of fluid into the subretinal space through the defective RPE. CSC most often affects men of working age. The exact pathophysiology of the disease is not completely known. Based on indocyanine green angiography (ICG), which revealed increased permeability of choroidal vessels, and optical coherence tomography (OCT) showing increased choroidal thickness, choroidal vasculopathy is assumed to be the primary cause of CSC. In most cases, CSC has a good prognosis with spontaneous resorption of the subretinal fluid (SRF) and improvement of visual functions. However, in a small percentage of patients the disease progresses to a chronic or recurrent course, and can lead to irreversible functional and anatomical changes of the retina with a final clinical picture of diffuse retinal pigment epitheliopathy (DRPE). The optimal treatment approach for patients with CSC remains controversial. In recent decades, myriad therapeutic approaches have been used in the treatment of chronic forms of CSC (cCSC); these included for example laser photocoagulation, pharmaceutical treatment, standard photodynamic therapy (PDT) or anti-VEGF. In recent years a less destructive method, specifically PDT in reduced dose regimens, either with a reduced dose of verteporfin or the laser beam energy used, has been preferred in the treatment of cCSC. Comparable efficacy and safety has been demonstrated using reduced-dose or reduced-fluence PDT regimens in patients with cCSC, with an improvement in best-corrected visual acuity and reduction of SRF.
摘要:
中心性浆液性脉络膜视网膜病变(CSC)是一种以神经视网膜浆液性脱离为特征的疾病,尤其是在眼睛的后极。它通常伴随着视网膜色素上皮(RPE)的浆液性脱离,并伴随着液体通过有缺陷的RPE泄漏到视网膜下隙中。CSC最经常影响工作年龄的男性。该疾病的确切病理生理学尚不完全清楚。基于吲哚菁绿血管造影(ICG),这表明脉络膜血管的渗透性增加,光学相干断层扫描(OCT)显示脉络膜厚度增加,脉络膜血管病变被认为是CSC的主要原因。在大多数情况下,CSC具有视网膜下液(SRF)的自发吸收和视觉功能改善的良好预后。然而,在一小部分患者中,疾病进展为慢性或复发性病程,并可导致视网膜不可逆的功能和解剖学变化,最终临床表现为弥漫性视网膜色素上皮病(DRPE)。CSC患者的最佳治疗方法仍存在争议。近几十年来,多种治疗方法已用于治疗慢性形式的CSC(cCSC);这些包括例如激光光凝,药物治疗,标准光动力疗法(PDT)或抗VEGF。近年来一种破坏性较小的方法,特别是减少剂量方案中的PDT,使用减少剂量的维替泊芬或使用的激光束能量,在cCSC的治疗中是优选的。在cCSC患者中,使用减少剂量或减少注量的PDT方案已证明具有相当的疗效和安全性。最佳矫正视力的改善和SRF的减少。