Multimodal imaging findings in a case of severe Central Serous Chorioretinopathy in an uncomplicated pregnancy.
Multimodal imaging findings in a case of severe Central Serous Chorioretinopathy in an uncomplicated pregnancy.
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DOI：
10.1186/s12886-015-0169-x
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发表时间：
2015-12-22
影响因子：
2
通讯作者：
Pertile G
中科院分区：
文献类型：
--
作者：
Maggio E;Polito A;Freno MC;Pertile G
中心性浆液性脉络膜视网膜病变（CSC）是一种罕见的妊娠并发症，通常在分娩后自行消退，极少或无后遗症。我们报告一例严重形式的CSC在一个简单的妊娠广泛的中央凹下渗出和严重的永久性视力丧失。采用多模态成像技术，包括彩色和无红色照片、近红外反射、荧光素血管造影和光谱域光学相干断层扫描，结果与视力变化相关。一位35岁孕妇，因左眼视力减退及变形而就诊。眼底检查显示中央凹下严重渗出伴后极浆液脱离。光学相干断层扫描（OCT）显示黄斑神经感觉脱离，伴有中央高反射性视网膜下物质。眼底多模态图像和血管造影显示急性期和终末期明显的临床特征。该疾病在分娩后随着视网膜下液的消退和中央凹下渗出物的消失而自然消退。然而，由于严重的萎缩性黄斑病变和中央凹下纤维化，视力没有改善。严重的CSC变异也可能出现在无并发症妊娠的病例中，并导致预后不良。认识到CSC的这些表现对于避免不当管理至关重要。多模态影像有助于明确诊断和突出临床特征。
Central Serous Chorioretinopathy (CSC) has been previously reported as an infrequent complication of pregnancy that usually resolves spontaneously after delivery, with minimal or no sequel. We report a case of a severe form of CSC in an uncomplicated pregnancy with extensive subfoveal exudates and severe permanent visual loss. Multimodal imaging techniques, including color and red-free photographs, near-infrared reflectance, fluorescein angiography, and spectral-domain optical coherence tomography, were performed and the findings were correlated to the changes in visual acuity. A 35-year-old pregnant woman presented with loss of vision and metamorphopsia in her left eye. Fundus examination showed subfoveal severe exudation with a posterior pole serous detachment. Optical coherence tomography (OCT) showed macular neurosensory detachment with central highly reflective sub-retinal material. Multimodal fundus pictures and angiograms revealed distinct clinical features of the disease during both the acute and final phase. The disease spontaneously resolved after delivery with regression of the subretinal fluid and the disappearance of subfoveal exudates. Nevertheless, because of severe atrophic macular changes and subfoveal fibrosis, no improvement of visual acuity was noted. Severe variants of CSC may also present in cases of uncomplicated pregnancy and result in a poor prognosis. Recognising these presentations of CSC is critical to avoid improper management. Multimodal imaging may help to clarify the diagnosis and highlight the clinical features.