Corticosteroids and central serous chorioretinopathy
Corticosteroids and central serous chorioretinopathy
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DOI：
10.1016/s0161-6420(02)01117-x
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发表时间：
2002-10-01
期刊：
影响因子：
13.7
通讯作者：
Iida, T
中科院分区：
文献类型：
--
作者：
Carvalho-Recchia, CA;Yannuzzi, LA;Iida, T
目的：本研究的目的是探讨皮质类固醇使用与中枢性浆液性脉络膜视网膜病变（CSC）的关系。设计：前瞻性病例对照研究。参与者和对照组：在2000年1月至2000年7月期间招募了一系列连续的CSC急性表现患者和一个年龄、种族和性别匹配的对照组。方法：对所有患者进行详细的临床病史和裂隙灯生物显微镜眼底检查。对研究患者进行荧光素血管造影。结果：共纳入50例患者。26例（52%）患者有外源性类固醇使用史，包括口服、静脉注射、鼻内和关节内给药。另外2例患者有内源性高皮质醇血症（库欣综合征）病史。在匹配的对照组中，8名患者（18%）有类固醇使用史。研究患者与对照组的皮质类固醇暴露差异有统计学意义（P < 0.0001）。主要观察指标：皮质类固醇使用史或库欣综合征。这项研究与先前有关类固醇使用与CSC的报道一致。它确定皮质类固醇是急性渗出性黄斑表现发展的重要危险因素，并暗示高皮质血症是这种疾病发病机制的一个因素。几种形式的皮质类固醇给药被观察到是CSC的危险因素。因此，需要皮质类固醇的易感患者应被告知有发生CSC急性表现的风险。(C) 2002年由美国眼科学会发布。
Purpose: The purpose of this study is to investigate the relationship between corticosteroid use and central serous chorioretinopathy (CSC).Design: A prospective, case-controlled study.Participants and Controls: A consecutive series of patients with acute manifestations of CSC and a control group matched for age, race, and gender were recruited between January 2000 and July 2000.Methods: A detailed clinical history was taken, and fundus examination with slit-lamp biomicroscopy was performed on all patients. Fluorescein angiography was obtained on the study patients.Results: A total of 50 patients was recruited. Twenty-six patients (52%) had a history of exogenous steroid use, including oral, intravenous, intranasal, and intraarticular administration. Two additional patients had a history of endogenous hypercortisolism (Cushing's syndrome). In a matched control group, eight patients (18%) had a history of steroid use. The difference in corticosteroid exposure between study patients and controls was statistically significant (P < 0.0001).Main Outcome Measures: History of corticosteroid use or Cushing's syndrome.Conclusions. This study is consistent with previous reports associating steroid use with CSC. It identifies corticosteroids as a significant risk factor for the development of acute, exudative macular manifestation and implicates hypercortisolism as a factor in the pathogenesis of this disorder. Several forms of corticosteroid administration were observed to be a risk factor for CSC. Accordingly, susceptible patients in need of corticosteroids should be advised of the risk of developing acute manifestations of CSC. (C) 2002 by the American Academy of Ophthalmology.