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1.
BMC Psychiatry ; 24(1): 368, 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38755608

RESUMEN

BACKGROUND: Psychotherapy for post-traumatic stress disorder, in particular trauma-confronting psychotherapy, can be associated with increased stress. However, research on the somatic impact and psychosomatic interactions of these psychological stress reactions is lacking. We report on a 43-year old man whose central serous chorioretinopathy exacerbated upon trauma-confronting psychotherapy. CASE PRESENTATION: We report on a man with pre-diagnosed, asymptomatic central serous chorioretinopathy who underwent inpatient psychosomatic therapy. He disclosed a history of sexual abuse by a family member and consequently showed intrusions, flashbacks, nightmares, avoidance behavior, and hyperarousal. Thus, we diagnosed post-traumatic stress disorder. After a stabilization phase, he underwent trauma-focused psychotherapy including trauma confrontation. In the course of this treatment, acute vision loss with blurred vision and image distortion of his right eye occurred. An ophthalmologic visit confirmed a relapse of a pre-diagnosed central serous chorioretinopathy. The analysis of stress biomarkers showed a decrease in testosterone levels and a noon peak in diurnal cortisol secretion, which is indicative of a stress reaction. CONCLUSION: Central serous chorioretinopathy may exacerbate upon psychotherapeutic treatment. In this case, an exacerbation of chorioretinopathy was observed in direct relation to the therapeutic intervention. Psychotherapists and ophthalmologists should collaborate in the psychotherapeutic treatment of patients with chorioretinopathy. Our case demonstrates the need to consider the possible increased stress levels during psychotherapy and resulting physical side effects, such as exacerbation of an existing condition. It is advisable to adjust the level of generated stress particularly well in the presence of stress-inducible physical diseases. Our case is a good example of the interplay between psychological and physical stress.


Asunto(s)
Coriorretinopatía Serosa Central , Psicoterapia , Trastornos por Estrés Postraumático , Humanos , Coriorretinopatía Serosa Central/psicología , Masculino , Adulto , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Psicoterapia/métodos
2.
Int Ophthalmol ; 44(1): 183, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38627308

RESUMEN

PURPOSE: To assess the positive effects of mindfulness-based stress reduction (MBSR) on the structural and functional outcomes of patients with central serous chorioretinopathy (CSCR). METHODS: This study included 60 patients with CSCR who were randomly allocated to one of two groups: MBSR or control (which did not practice MBSR). These groups were then evaluated in terms of best corrected visual acuity (BCVA) and central macular thickness (CMT) at months 1, 3, and 6. RESULTS: There were no significant differences in BCVA or mean CMT between the groups at the beginning of the study (p = 0.615 and p = 0.561, respectively). There were statistically significant differences between the groups in terms of BCVA at 1, 3, and 6 months (p = 0.018, p = 0.001, and p = 0.002, respectively). There were also significant differences in the mean CMT across the groups at the first, third, and sixth months (p < 0.001, p = 0.001, and p < 0.001, respectively). CONCLUSION: MBSR may have beneficial outcomes in the early treatment of patients with CSCR, resulting in faster resolution of subretinal fluid and enhancement of BCVA.


Asunto(s)
Coriorretinopatía Serosa Central , Atención Plena , Humanos , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/terapia , Angiografía con Fluoresceína , Enfermedad Aguda , Agudeza Visual , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos
3.
Medicine (Baltimore) ; 103(16): e37855, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38640292

RESUMEN

RATIONALE: The bullous variant of central serous chorioretinopathy (CSC) is a severe form of chronic CSC. Patients with the bullous variant of CSC have an increased risk of experiencing multiple pigment epithelial detachments (PEDs) and retinal pigment epithelium (RPE) tears. Photodynamic therapy (PDT) is a treatment for the bullous variant of CSC. RPE tear is a possible postoperative complication of PDT for eyes with PEDs. To our knowledge, no cases of giant RPE tears following PDT for the bullous variant of CSC have been reported previously. This case report presents the first instance of a giant RPE tear after half-time PDT for the bullous variant of CSC, accompanied by a series of images depicting the tear development. PATIENT CONCERNS: A 63-year-old male patient presented with rapidly deteriorating vision in his left eye over a 3-month period. He also reported a previous episode of vision loss in his right eye 2 years prior. Best-corrected visual acuity (BCVA) in the left eye was 0.2. DIAGNOSIS: The right eye was diagnosed with chronic non-bullous CSC, while the left eye was diagnosed with the bullous variant of CSC with a large PED. INTERVENTIONS: Half-time PDT was administered to the left eye. OUTCOMES: One month after half-time PDT, a giant RPE tear exceeding 3 clock-hours in size was confirmed in the lower temporal quadrant of the left eye. Three months after the initial half-time PDT, a second half-time PDT was performed owing to recurrent retinal detachment. Two months after the second half-time PDT, the retinal detachment resolved, and BCVA improved to 0.4, 6 months after the second half-time PDT. LESSONS: In cases where the bullous variant of CSC is complicated by extensive PED, clinicians should consider the potential development of a giant RPE tear as a treatment complication.


Asunto(s)
Coriorretinopatía Serosa Central , Fotoquimioterapia , Desprendimiento de Retina , Perforaciones de la Retina , Masculino , Humanos , Persona de Mediana Edad , Coriorretinopatía Serosa Central/inducido químicamente , Coriorretinopatía Serosa Central/tratamiento farmacológico , Coriorretinopatía Serosa Central/complicaciones , Desprendimiento de Retina/etiología , Fotoquimioterapia/efectos adversos , Fotoquimioterapia/métodos , Agudeza Visual , Perforaciones de la Retina/cirugía , Perforaciones de la Retina/complicaciones , Angiografía con Fluoresceína , Pigmentos Retinianos/uso terapéutico , Tomografía de Coherencia Óptica , Fármacos Fotosensibilizantes/efectos adversos , Estudios Retrospectivos
4.
BMC Ophthalmol ; 24(1): 176, 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38632531

RESUMEN

OBJECTIVE: In this study, we used ultra-wide field swept-source optical coherence tomography angiography (UWF SS-OCTA) to assess changes in retinal thickness (RT) and choroidal parameters in individuals who had received a diagnosis of central serous chorioretinopathy (CSC). METHODS: The study encompassed the evaluation of 59 eyes from 47 patients with a diagnosis of CSC, alongside 33 fellow eyes and 31 eyes from healthy individuals (controls). The parameters assessed included RT, choroidal thickness (CT), choriocapillaris density, vascular density of the large choroidal vessel layer, three-dimensional choroidal vascularity index (3D-CVI), choroidal vessel volume per unit area (mCVV/a), and choroidal stroma volume per unit area (mCSV/a). RESULTS: Metrics including mCVV/a, mCSV/a, 3D-CVI, CT, and RT exhibited significantly elevated values in the eyes affected by CSC compared to those of the control group across nine subfields. Moreover, a substantial number of the subfields in both CSC-affected and fellow eyes exhibited increased values for mCVV/a, mCSV/a, 3D-CVI, CT, and RT when compared with the control group. Additionally, acute and chronic CSC subfields demonstrated significantly elevated values for mCVV/a, mCSV/a, 3D-CVI, CT, and RT in comparison to healthy control eyes. Notably, specific subfields associated with complex and atypical forms of CSC revealed higher metrics compared to those of the control group. CONCLUSION: In conclusion, the UWF SS-OCTA proved to be a valuable tool for exploring the anatomical etiology and clinical classification and diagnosis of CSC.


Asunto(s)
Coriorretinopatía Serosa Central , Humanos , Coriorretinopatía Serosa Central/diagnóstico , Estudios Transversales , Angiografía con Fluoresceína/métodos , Tomografía de Coherencia Óptica/métodos , Agudeza Visual , Coroides/irrigación sanguínea , Estudios Retrospectivos
5.
Klin Monbl Augenheilkd ; 241(4): 489-495, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38653299

RESUMEN

PURPOSE: To evaluate the efficacy of a subthreshold micropulse laser (SML) in patients with central serous chorioretinopathy (CSCR). METHODS: Retrospective clinical study conducted at the Departments of Ophthalmology at a university and a municipal hospital in Zurich, Switzerland. We enrolled acute and chronic CSCR patients with persistent subretinal fluid (SRF) treated with SML. Two treatment protocols (fluorescein/indocyanine green angiography or optical coherence tomography guided) were evaluated for efficacy after 3 and 6 months. The primary outcomes of the study were reduction and percentage of eyes with complete resolution of SRF 3 and 6 months after SML treatment. Secondary endpoints included changes in central subfield thickness (CST) and visual acuity (VA) after 3 and 6 months. RESULTS: The study involved 37 eyes (35 patients, 48.6% chronic). A statistically significant reduction in SRF height and CST could be shown, irrespective of SRF duration, type of CSCR, or chosen guidance after 3 and 6 months: SRF - 40 µm (p < 0.01), CST - 52 µm (p < 0.01). Percentage of eyes with complete resolution of fluid at 3 and 6 months after SML were 24.3 and 21.6%, respectively. No statistically significant functional improvement (VA) could be shown. Multivariable regression and linear mixed regression analyses did not identify statistically significant differences in SRF reduction, CMT change, or VA improvement with respect to the type of CSCR or the treatment plan used (p > 0.05). CONCLUSION: The effectiveness of SML in CSCR is under continuous debate. Our study findings demonstrate structural but only little functional changes with SML. In view of the shortage of verteporfin for photodynamic therapy, SML remains an important therapeutic option for CSCR patients.


Asunto(s)
Coriorretinopatía Serosa Central , Humanos , Coriorretinopatía Serosa Central/cirugía , Coriorretinopatía Serosa Central/diagnóstico por imagen , Masculino , Femenino , Resultado del Tratamiento , Persona de Mediana Edad , Estudios Retrospectivos , Adulto , Agudeza Visual , Coagulación con Láser/métodos , Anciano , Líquido Subretiniano
6.
BMC Ophthalmol ; 24(1): 147, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38566166

RESUMEN

PURPOSE: This study aims to present long-term observation of 5 eyes with focal choroidal excavation (FCE), focusing on morphological changes in conformity of the lesion. METHODS: A retrospective case series was conducted, including 5 eyes of 5 patients with FCE. The study utilized multimodal imaging including color fundus photography, optical coherence tomography (OCT), enhanced depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA), fundus autofluorescence (FAF), red free imaging, and OCT angiography. RESULTS: The mean age at diagnosis was 51 ± 10.65 years, with a mean follow-up period 37 ± 13.59 months. All cases were unilateral, with 1 presenting FCE as an isolated lesion, and one patient exhibiting 2 FCEs in one eye. The mean choroidal thickness measured by EDI-OCT was 268.2 ± 63.39 µm in the affected eye. One patient displayed choroidal thickening and pachyvessels. Of the 5 eyes, one had conforming and 4 non-conforming FCE. We observed a conversion in conformity in all patients, with 4 cases transitioning from non-conforming FCE to conforming type (3 spontaneously, 1 treatment-induced). In conforming FCE, a hyporeflective space appeared twice between neuroretina and retinal pigment epithelium with spontaneous regression. CONCLUSION: We observed change in shape from the conforming to non-conforming FCE and vice versa in all patients. We consider this small change in the hyporeflective space as non-pathologic and clinically insignificant.


Asunto(s)
Coriorretinopatía Serosa Central , Enfermedades de la Coroides , Humanos , Adulto , Persona de Mediana Edad , Enfermedades de la Coroides/diagnóstico por imagen , Enfermedades de la Coroides/patología , Estudios de Seguimiento , Estudios Retrospectivos , Coriorretinopatía Serosa Central/patología , Coroides/patología , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos
8.
Doc Ophthalmol ; 148(3): 145-153, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38498077

RESUMEN

PURPOSE: We evaluate morphological and functional correlations in patients with acute central serous chorioretinopathy (CSC). METHODS: A prospective study was conducted on 50 patients with an acute CSC episode lasting less than 3 months. At baseline, assessments included optical coherence tomography (OCT), best-corrected visual acuity (BCVA), contrast sensitivity (CS), microperimetry (MP), and multifocal electroretinography (mfERG). A correlation analysis between OCT morphological parameters (maximal subretinal fluid height (SRF), central retinal thickness (CRT), and macular volume (MV)) and functional parameters was conducted on the affected eye for each patient. RESULTS: Among the morphological parameters, SRF showed the strongest correlations with functional parameters (r absolute value range = 0.10-0.70). Weak correlations were observed between BCVA and morphological parameters (r absolute value range = 0.14-0.26). Average retinal sensitivity (MP-A) was the functional parameter displaying the most robust negative correlation with morphological parameters (r absolute value range = 0.61-0.70). In contrast, average contrast sensitivity (CS-A) and mfERG average amplitude density in the first (mfERG-A1) and second (mfERG-A2) ring showed weak to moderate (r absolute value range = 0.35-0.56) yet statistically significantly nonzero correlations. CONCLUSIONS: SRF and CRT could serve as the most representative morphological proxies for visual function deficit in acute CSC patients. Retinal sensitivity, as measured by MP, may be superior to BCVA in clinical research studies or when an in-depth visual function evaluation is needed.


Asunto(s)
Coriorretinopatía Serosa Central , Sensibilidad de Contraste , Electrorretinografía , Angiografía con Fluoresceína , Retina , Tomografía de Coherencia Óptica , Agudeza Visual , Pruebas del Campo Visual , Humanos , Coriorretinopatía Serosa Central/fisiopatología , Coriorretinopatía Serosa Central/diagnóstico , Estudios Prospectivos , Agudeza Visual/fisiología , Masculino , Femenino , Enfermedad Aguda , Adulto , Persona de Mediana Edad , Sensibilidad de Contraste/fisiología , Retina/fisiopatología , Retina/diagnóstico por imagen , Retina/patología , Campos Visuales/fisiología , Líquido Subretiniano/diagnóstico por imagen
9.
J Int Med Res ; 52(3): 3000605241233963, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38436326

RESUMEN

We herein present a rare case of acute central serous chorioretinopathy (CSC) associated with nonspecific orbital inflammation (NSOI). A 38-year-old woman presented with a 3-day history of ocular pain, reduced vision, periorbital swelling, proptosis, conjunctival chemosis, and restricted eye movements. Optical coherence tomography of the affected eye confirmed signs of CSC. Additionally, a computed tomography scan revealed enlargement of intraconal soft tissues and the lacrimal gland. Ocular ultrasonography detected posterior sclera thickening, indicating posterior scleritis. Following the diagnosis of NSOI, the patient received treatment with systemic corticosteroids, resulting in gradual regression of both the orbital inflammation and CSC. This is the first reported case of localized posterior pole CSC documented in a patient with NSOI. Vigilant monitoring for any ocular disorders is important in patients with orbital inflammation.


Asunto(s)
Coriorretinopatía Serosa Central , Femenino , Humanos , Adulto , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/diagnóstico por imagen , Inflamación , Ojo , Cara , Hipertrofia
10.
Cesk Slov Oftalmol ; 80(2): 59-75, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38531681

RESUMEN

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.


Asunto(s)
Coriorretinopatía Serosa Central , Fotoquimioterapia , Porfirinas , Masculino , Humanos , Fármacos Fotosensibilizantes/uso terapéutico , Fotoquimioterapia/métodos , Agudeza Visual , Angiografía con Fluoresceína/métodos , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Porfirinas/uso terapéutico
11.
Int Ophthalmol ; 44(1): 131, 2024 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-38478131

RESUMEN

PURPOSE: To compare functional and morphological outcomes of Subthreshold Laser (STL) and Oral Spironolactone (SPR) in treating chronic central serous chorioretinopathy (CSCR). METHODS: This is a retrospective observational study. Treatment-naïve patients with chronic CSCR treated with STL or SPR were included, and data was reviewed at baseline, 1, 3, 6 and 12-month follow-up. Main outcome measures were changes in Central Macular Thickness (CMT) and Subretinal Fluid (SRF) height, and complete resolutions of SRF. Sub-analysis based on retinal pigmented epithelium (RPE) status at baseline was performed. RESULTS: 47 and 47 patients received STL and SPR, respectively. At all timepoints, both treatments significantly improved CMT and SRF (p < 0.05). No significant changes in best corrected visual acuity (BCVA) were recorded and no significant differences between treatment groups were present at each corresponding follow-up. Complete resolution of SRF was achieved in 29% and 36% of patients treated with STL or SPR, respectively, at 12-months follow up. Eyes treated with STL and intact RPE showed significant SRF decrease at 6 months and significantly better BCVA at 1, 3 and 6 months compared to eyes with disrupted RPE layer (p < 0.05). In both treatment groups, intact RPE was associated with a higher rate of complete SRF resolutions, with 43% vs 13% in the STL group and 50% vs 26% in the SPR group. CONCLUSION: STL and SPR are effective treatments for chronic CSCR. Greater resolution of subretinal fluid was observed in eyes with intact RPE, hence both treatments should be initiated in the earlier stages of the disease.


Asunto(s)
Coriorretinopatía Serosa Central , Espironolactona , Humanos , Espironolactona/uso terapéutico , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/tratamiento farmacológico , Estudios Retrospectivos , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Angiografía con Fluoresceína , Tomografía de Coherencia Óptica , Rayos Láser , Enfermedad Crónica
14.
BMC Ophthalmol ; 24(1): 92, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38424605

RESUMEN

BACKGROUND: Central serous chorioretinopathy (CSC) has frequently been associated with increased stress levels as well as an increased prevalence of other psychiatric conditions. This study used standardized psychometric scores to assess stress, depression and anxiety levels of CSC patients and compared them to controls without retinal disease ("healthy") and with branch retinal vein occlusion (BRVO). METHODS: Monocentric, longitudinal case control study on consecutive CSC patients seen at a tertiary referral center. Controls without retinal disease were recruited from the oculoplastics clinic and those with BRVO from the medical retina clinic. Patients completed pseudonymized tests measuring stress levels (PHQ-stress), depression (PHQ-9) and anxiety (GAD-7) at baseline and at 3- and 6-months follow-up. Higher scores indicated higher trait levels. RESULTS: 65 CSC patients, 19 healthy controls and 19 BRVO patients were included in this study. CSC patients showed significantly higher stress levels at baseline compared to controls (p = 0.009), but not compared to BRVO patients (p = 1.00). At 3- and 6-months follow-up, no significant difference between groups was observed anymore. Acute CSC patients showed higher scores than those with chronic CSC, which also subsided over time. Depression and anxiety scores did not differ between groups at any timepoint. CONCLUSIONS: Patients with CSC do not show higher initial stress levels than patients with BRVO, while anxiety and depression levels did not differ from controls. Stress may thus rather represent a consequence of the onset of visual deterioration observed in CSC or other ocular diseases.


Asunto(s)
Coriorretinopatía Serosa Central , Humanos , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/complicaciones , Estudios de Casos y Controles , Psicometría , Retina , Tomografía de Coherencia Óptica , Angiografía con Fluoresceína
15.
Lasers Med Sci ; 39(1): 83, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38418639

RESUMEN

PURPOSE: To evaluate the changes in macular structures following subthreshold micropulse laser (SHML) treatment for chronic central serous chorioretinopathy (cCSC). METHODS: Data of 33 eyes from 31 cCSC patients treated with SHML and followed up for at least 6 months has been included in this retrospective study. Main outcome measurements include resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), the recovery of ellipsoid zone (EZ) continuity, and the foveal outer nuclear layer (ONL) thickness along with its ratio. RESULTS: Mean observation period is 7.355 months (ranging from 6 to 24 months) and mean number of treatments administered is 1.839 (ranging from 1 to 5). 6 months after SHML treatment, there is a significant decrease in the area of SRF and PED (P < 0.001, P = 0.010, respectively). Additionally, the frequency of continuous EZ and the foveal ONL thickness reveal a significant increase (P<0.001, P = 0.005, respectively). The ratio of foveal ONL thickness is significantly higher after laser treatment, particularly in patients with a disease duration of ≤12 months (p = 0.022, P=0.036, respectively). CONCLUSION: SHML treatment proves to be effective in cCSC eyes, leading to satisfactory recovery of macular structures, especially the photoreceptor layer.


Asunto(s)
Coriorretinopatía Serosa Central , Terapia por Láser , Humanos , Coriorretinopatía Serosa Central/radioterapia , Coriorretinopatía Serosa Central/cirugía , Estudios Retrospectivos , Angiografía con Fluoresceína , Agudeza Visual , Retina , Tomografía de Coherencia Óptica , Enfermedad Crónica
16.
Asia Pac J Ophthalmol (Phila) ; 13(1): 100003, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38383077

RESUMEN

PURPOSE: To evaluate the genetic associations of different subtypes of central serous chorioretinopathy (CSCR), neovascular age-related macular degeneration (nAMD), and polypoidal choroidal vasculopathy (PCV). DESIGN: A case-control genetic association study. METHODS: This study enrolled 217 CSCR, 341 nAMD, 288 PCV patients, and 1380 controls. The CSCR patients were classified into those with focal or diffuse leakage, with or without pigment epithelial detachment (PED), and with or without macular neovascularization (MNV). Associations between 11 variants from 8 genes, ADAMTS9, ANGPT2, ARMS2, CFH, NR3C2, PGF, TNFRSF10A and VIPR2, and diseases/subtypes were analyzed by logistic regression analysis adjusted for age and sex, and inter-phenotype comparison by heterogeneity test. RESULTS: The CFH rs800292-A conferred a protective effect for CSCR with MNV (OR=0.44, P = 0.002) and a risk effect for CSCR without MNV (OR=1.31, P = 0.023). CSCR patients carrying rs800292-G had a 3.23-fold of increased risk towards developing secondary MNV (P = 1.45 ×10-4). CFH rs3753394, rs800292 and rs1329428 showed similar effects among CSCR with MNV, nAMD and PCV, but opposite effects on CSCR without MNV. TNFRSF10A rs13278062-T was associated with overall CSCR but not with CSCR subtypes, nAMD or PCV. Moreover, CFH and ARMS2 SNPs showed heterogeneous effects in CSCR without MNV against CSCR with MNV, nAMD and PCV. CONCLUSIONS: Genetic associations of CSCR with MNV resembled nAMD and PCV compared to CSCR without MNV, indicating differential genetic effects on neovascularization and choroidopathy. Further investigation of the functional roles of CFH, ARMS2, and TNFRSF10A in CSCR, nAMD and PCV should help elucidate the mechanisms of these maculopathies.


Asunto(s)
Coriorretinopatía Serosa Central , Neovascularización Coroidal , Degeneración Macular , Humanos , Genotipo , Coriorretinopatía Serosa Central/genética , Vasculopatía Coroidea Polipoidea , Polimorfismo de Nucleótido Simple , Degeneración Macular/genética , Neovascularización Coroidal/genética , Angiografía con Fluoresceína
17.
Graefes Arch Clin Exp Ophthalmol ; 262(6): 1755-1763, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38224344

RESUMEN

PURPOSE: To compare the efficacy of brolucizumab, half-dose PDT, and aflibercept in treating chronic central serous chorioretinopathy (CSC). METHODS: A retrospective cohort study with chronic CSC patients who underwent intravitreal injection of one shot of brolucizumab or aflibercept in the first 3 months, followed by pro re nata regimens or a single session of half-dose PDT, was retrospectively reviewed. The primary outcome measure was the proportion of eyes that achieved complete absorption of retinal fluid without requiring any rescue treatment. Secondary outcomes included changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and central choroidal thickness (CCT). RESULTS: A total of 54 consecutive patients were included in this study with 18 patients in each group. At months 1 and 2, the brolucizumab group exhibited the highest rate of complete retinal fluid resolution (61% and 77%), followed by the half-dose PDT group (56% and 72%), and lowest in the aflibercept group (28% and 33%), with statistically significant differences noted at month 2 (P = 0.012). The brolucizumab group also demonstrated the most significant reduction in CCT at months 1 and 2 among the three groups (P = 0.007 and 0.001). Recurrence of retinal fluid in the brolucizumab groups was predominantly observed at month 3. Conversely, the half-dose PDT group exhibited the most favorable anatomical results starting from month 3. Notably, mild vitritis was observed in one case from the brolucizumab group. CONCLUSIONS: Single injection of brolucizumab demonstrates trends of faster regression of persistent residual retinal fluid, greater CCT and CRT decline, and matched BCVA compared to half-dose PDT in the short term.


Asunto(s)
Inhibidores de la Angiogénesis , Coriorretinopatía Serosa Central , Angiografía con Fluoresceína , Inyecciones Intravítreas , Fotoquimioterapia , Receptores de Factores de Crecimiento Endotelial Vascular , Proteínas Recombinantes de Fusión , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Proteínas Recombinantes de Fusión/administración & dosificación , Receptores de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Coriorretinopatía Serosa Central/tratamiento farmacológico , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/fisiopatología , Estudios Retrospectivos , Masculino , Femenino , Fotoquimioterapia/métodos , Enfermedad Crónica , Inhibidores de la Angiogénesis/administración & dosificación , Resultado del Tratamiento , Persona de Mediana Edad , Estudios de Seguimiento , Adulto , Fármacos Fotosensibilizantes/administración & dosificación , Fármacos Fotosensibilizantes/uso terapéutico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Fondo de Ojo , Relación Dosis-Respuesta a Droga , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Retina/patología
18.
BMC Ophthalmol ; 24(1): 8, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-38178104

RESUMEN

BACKGROUND: To compare real-life anatomical and functional outcomes of half-dose photodynamic therapy (HD-PDT) and 577 nm subthreshold pulse laser therapy (SPL) in treatment-naïve patients with central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed consecutive treatment-naïve CSC patients with non-resolving subretinal fluid (SRF) for more than 2 months who received either HD-PDT or SPL treatment. One repetition of the same treatment was allowed in patients with persistent SRF after first treatment. Functional and anatomical outcomes were assessed after first treatment and at final visit. RESULTS: We included 95 patients (HD-PDT group, n = 49; SPL group, n = 46). Complete resolution of SRF after a single treatment was observed in 42.9% of HD-PDT-treated patients (n = 21; median time to resolution 7.1 weeks) and in 41.3% of SPL-treated patients (n = 19; median time to resolution 7.0 weeks). In the HD-PDT-group, 44.9% of patients (n = 22) and in the SPL-group, 43.5% (n = 20) of patients, received a second treatment due to persistent SRF, while 12.2% (n = 6) and 15.2% (n = 7), respectively, opted against a second treatment despite persistent SRF. After the final treatment, complete SRF resolution was observed in 61.2% of all HD-PDT-treated patients (n = 30; median time to resolution 8.8 weeks) and 60.9% of all SPL-treated patients (n = 28; median time to resolution 13.7 weeks, p = 0.876). In the final visit, both groups showed significant improvement of BCVA in comparison to baseline (p < 0.001 for all). The change in BCVA from baseline to final visit was similar for the two groups (HD-PDT, median BCVA change 0.10 logMAR (IQR: 0.0-0.2); in SPL group, median BCVA change 0.10 logMAR (IQR: 0.0-0.2), P = 0.344). The CSC subclassification (simple versus complex) had no influence on the anatomical or functional outcome. CONCLUSIONS: High-density 577 nm SPL resulted in as good anatomical and functional treatment as HD-PDT and may thus represent a treatment alternative to HD-PDT in CSC.


Asunto(s)
Coriorretinopatía Serosa Central , Terapia por Láser , Fotoquimioterapia , Humanos , Fármacos Fotosensibilizantes/uso terapéutico , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/tratamiento farmacológico , Verteporfina/uso terapéutico , Estudios Retrospectivos , Estudios de Seguimiento , Fotoquimioterapia/métodos , Terapia por Láser/métodos , Tomografía de Coherencia Óptica , Angiografía con Fluoresceína , Enfermedad Crónica
19.
Sci Rep ; 14(1): 821, 2024 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-38191653

RESUMEN

In this retrospective longitudinal cohort study, we investigated the temporal changes in the peripapillary retinal nerve fiber layer (pRNFL) and inner retinal thickness in patients with acute central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (SD-OCT). We followed up with these patients for 6 months, and during this period, the thickness of the pRNFL and the ganglion cell complex (GCC) in CSC patients were compared with the eyes of normal healthy individuals. The study also examined the correlation between the pRNFL thickness, GCC thickness, and visual acuity. The research sample consisted of 67 patients (43 male and 24 female) with an average age of 49.72 ± 9.87 years. The initial findings showed no significant differences in the pRNFL and GCC thickness between the study and fellow eye, study and normal healthy eyes, and fellow and normal healthy eyes. There was no significant difference in the pRNFL and GCC thickness when comparing the study eye with the fellow eye for 6 months. In the study eye, no significant difference was observed when comparing the initial GCC and pRNFL thickness with those at 1, 3, and 6 months. Visual acuity improved significantly from 0.18 ± 0.23 logMAR to 0.04 ± 0.06 logMAR (p < 0.001). The GCC and pRNFL thickness did not significantly affect visual acuity. In conclusion, acute CSC patients did not show significant changes in the pRNFL and inner retinal thickness, suggesting that the GCC and pRNFL do not substantially influence the short-term visual prognosis in these patients.


Asunto(s)
Coriorretinopatía Serosa Central , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Coriorretinopatía Serosa Central/diagnóstico por imagen , Tomografía de Coherencia Óptica , Estudios Longitudinales , Estudios Retrospectivos , Retina/diagnóstico por imagen , Enfermedad Aguda
20.
Ophthalmic Surg Lasers Imaging Retina ; 55(2): 96-99, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38198608

RESUMEN

This report describes a case of bilateral, simultaneous central serous chorioretinopathy (CSCR) in a young woman on oral contraceptive pills (OCP). A 21-year-old woman with a negative past medical history presented with sudden onset of bilateral decreased vision shortly after starting OCP. Comprehensive ocular examination revealed bilateral central serous chorioretinopathy (CSCR), confirmed on retinal optical coherence tomography (OCT) and intravenous fluorescein angiography. The patient was instructed to discontinue OCP, and three weeks later, there was complete resolution of the visual symptoms and of the bilateral serous retinal detachments, documented on OCT. [Ophthalmic Surg Lasers Imaging Retina 2024;55:96-99.].


Asunto(s)
Coriorretinopatía Serosa Central , Desprendimiento de Retina , Femenino , Humanos , Adulto Joven , Adulto , Coriorretinopatía Serosa Central/inducido químicamente , Coriorretinopatía Serosa Central/diagnóstico , Retina , Desprendimiento de Retina/diagnóstico , Angiografía con Fluoresceína , Tomografía de Coherencia Óptica/métodos , Anticoncepción
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