ACUTE CENTRAL SEROUS CHORIORETINOPATHY: Factors Influencing Episode Duration.
ACUTE CENTRAL SEROUS CHORIORETINOPATHY: Factors Influencing Episode Duration.
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DOI：
10.1097/iae.0000000000001443
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发表时间：
2017-10
期刊：
影响因子：
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通讯作者：
Behar-Cohen F
中科院分区：
文献类型：
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作者：
Daruich A;Matet A;Marchionno L;De Azevedo JD;Ambresin A;Mantel I;Behar-Cohen F
通过生存分析对影响首次、急性和未经治疗的CSCR发作持续时间的临床和多模式成像因素的调查表明，中心凹下脉络膜厚度较高、渗漏部位较高的色素上皮脱离或隆起以及年龄较大是较长发作的独立预测因素。目的探讨临床和多模式成像参数对急性中心性浆液性脉络膜视网膜病变(CSCR)病程的影响。前瞻性纳入在症状出现后20天内首次出现单纯治疗的中心性浆液性脉络膜视网膜病变的连续患者。15天至20天后进行复评，6个月后按月复评。用单因素和多因素生存分析评估黄斑下脉络膜厚度(SFCT)、荧光素血管造影的荧光素渗漏强度、渗漏部位视网膜色素上皮(RPE)病变的升高、吲哚青绿血管造影(ICGA)的局灶性/多灶性模式、OCT上视网膜下液(SRF)吸收的时间依赖性模式、皮质类固醇摄入史和平均血压。入选患者31例(男26例，女5例，年龄24~58岁，平均40.0±8.9岁)，其中26例(84%)在6个月内症状消失。单因素分析显示，黄斑下脉络膜厚度≥500μm(P=0.0002)、视网膜色素上皮渗漏部位≥50μm(P=0.033)、视网膜下液高峰(P=0.013)的患者发病时间较长，且荧光素强渗漏(P=0.074)与发病时间的延长有非常显著的相关性。经多因素分析，黄斑下脉络膜厚度≥500μm(P=0.017)、渗漏部位视网膜色素上皮高度≥50μm(P=0.010)和患者年龄≥40岁(P=0.010)与长发作显著相关。吲哚青绿血管造影术模式、皮质类固醇摄入量和血压不影响发作持续时间。年龄较大、中心凹下脉络膜厚度较高、渗漏部位视网膜色素上皮病变程度较高是急性中心性浆液性脉络膜视网膜病变发病时间较长的独立因素。
The investigation of clinical and multimodal imaging factors influencing the duration of first, acute, and treatment-naive CSCR episodes by survival analysis showed that higher subfoveal choroidal thickness, higher pigment epithelial detachment or bump at leakage sites, and older age were independent predictors of longer episodes. To evaluate the influence of clinical and multimodal imaging parameters on the duration of acute central serous chorioretinopathy (CSCR) episodes. Consecutive patients with first, treatment-naïve central serous chorioretinopathy episodes presenting within 20 days of symptoms onset were prospectively included. They were reevaluated 15 days to 20 days later, followed by monthly evaluation for 6 months. Subfoveal choroidal thickness (SFCT), fluorescein leakage intensity on fluorescein angiography, elevation of retinal pigment epithelium (RPE) lesions at leakage sites, focal/multifocal pattern of indocyanine green angiography (ICGA) at baseline, time-dependent pattern of subretinal fluid (SRF) resorption on OCT using volume segmentation, history of corticosteroid intake and mean blood pressure were evaluated using univariate (Log rank test) and multivariate (Cox proportional hazard regression) survival analysis. Thirty-one patients were included (26 men, 5 women, mean age: 40.0 ± 8.9 years, range: 24–58), of which 26 (84%) had episode resolution by 6 months. Using univariate analysis, episode duration was longer in cases with subfoveal choroidal thickness ≥500 μm (P = 0.0002), retinal pigment epithelium elevation at leakage sites ≥50 μm (P = 0.033), and a peak in subretinal fluid observed during follow-up (P = 0.013), and there was a near-significant association of intense fluorescein leakage (P = 0.074) with longer episodes. Using multivariate analysis, subfoveal choroidal thickness ≥500 μm (P = 0.017), retinal pigment epithelium elevation at leakage sites ≥50 μm (P = 0.010) and patient age ≥40 years (P = 0.010) were significantly and independently associated to longer episodes. Indocyanine green angiography pattern, corticosteroid intake, and blood pressure did not influence episode duration. Older age, higher subfoveal choroidal thickness, and higher degree of retinal pigment epithelium alteration at leakage sites are independent factors of longer acute central serous chorioretinopathy episodes.