La tomografía de coherencia óptica en el diagnóstico y evolución de la coroidopatía lúpica. Reporte de caso

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune que afecta múltiples órganos incluidos los ojos. Entre las manifestaciones oculares del LES se encuentra la coroidopatía lúpica (CL), afección poco frecuente, pero de importantes repercusiones visuales si no se trata oportunamente. Se presenta el caso de una paciente de 41 años que desarrolló una CL durante la reducción de su terapia corticoesteroidea para el LES, estudiada con angiofluoresceinografía retiniana y tomografía de coherencia óptica (OCT) para el diagnóstico y seguimiento de su compromiso ocular. Tanto las fugas del colorante como los desprendimientos serosos de retina cedieron con el tratamiento de altas dosis de prednisona, pero recurrieron en dos oportunidades a pesar del control de la enfermedad de fondo. Se enfatizan las características clínicas para permitir su reconocimiento, resaltando el uso de la OCT para su diagnóstico y seguimiento luego del tratamiento.

SUMMARY Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs including the eyes. Among the ocular manifestations of SLE is lupus choroidopathy, a rare condition but with significant visual repercussions if not treated promptly. We present the case of a 41-year-old woman who developed a lupus choroidopathy during the reduction of the dose of corticosteroid therapy for SLE, studied with retinal angiofluoresceinography and OCT for the diagnosis and follow-up of her ocular involvement. Both the dye leaks and the serous retinal detachments resolved with the treatment of high doses of prednisone but recurred twice despite the control of the underlying disease. The clinical characteristics are emphasized to allow its recognition, highlighting the use of optical coherence tomography (OCT) for its diagnosis and follow-up after treatment.

A potential side effect of oral topical steroids: Central serous chorioretinopathy

Topical corticosteroids are some of the most common drugs used in oral medicine for treating atrophic and erosive lesions that affect the mucosa. Adverse effects of these drugs include oral candidiasis with associated burning mouth and hypogeusia, hypersensitive reactions to the drug, and inhibition of the hypothalamic–pituitary–adrenal axis and secondary adrenal insufficiency. The ocular side effects of oral topical steroids are less documented. This short communication describes a case of central serous retinopathy that developed following administration of oral topical steroid.

Clinical analysis of Walit in the treatment of central serous retinopathy / 中国生化药物杂志

Objective To investigate the clinical effect of Walit on central serous retinopathy. Methods A total of 92 patients with central serous retinal retinopathy were enrolled in our hospital from January 2015 to January 2017, and were randomly divided into control group and study group (n=46). The control group, the central serous chorioretinopathy treated with laser therapy, the study group by laser combined with Walit therapy, two groups were treated for 4 weeks, the curative effect and follow-up records, the data input SPSS software. Results The two groups of central serous chorioretinopathy patients successfully completed the treatment. The study group central serous chorioretinopathy in patients with clinical therapy in the treatment of the total efficiency (91.30 %) was significantly better than the control group (76.09 %), the differences were statistically significant (P<0.05); recurrence rate of study group (0.00 %) was significantly lower than the control group (13.04 %), the differences were statistically significant (P<0.05). Conclusion The use of laser treatment for central serous chorioretinopathy combined with Wolitingke significantly improve curative effect, has the positive significance to guarantee the prognosis and quality of life.

Clinical analysis of Walit in the treatment of central serous retinopathy / 中国生化药物杂志

Objective To investigate the clinical effect of Walit on central serous retinopathy. Methods A total of 92 patients with central serous retinal retinopathy were enrolled in our hospital from January 2015 to January 2017, and were randomly divided into control group and study group (n=46). The control group, the central serous chorioretinopathy treated with laser therapy, the study group by laser combined with Walit therapy, two groups were treated for 4 weeks, the curative effect and follow-up records, the data input SPSS software. Results The two groups of central serous chorioretinopathy patients successfully completed the treatment. The study group central serous chorioretinopathy in patients with clinical therapy in the treatment of the total efficiency (91.30 %) was significantly better than the control group (76.09 %), the differences were statistically significant (P<0.05); recurrence rate of study group (0.00 %) was significantly lower than the control group (13.04 %), the differences were statistically significant (P<0.05). Conclusion The use of laser treatment for central serous chorioretinopathy combined with Wolitingke significantly improve curative effect, has the positive significance to guarantee the prognosis and quality of life.

Visual outcome of central serous retinopathy.

Background: Central serous chorioretinopathy (CSCR) is a sporadic disorder of the outer blood retinal barrier. Increasing evidence implicates an abnormal choroidal circulation as the cause of CSCR. The study aimed at the visual outcome of central serous retinopathy for a duration of 6 months from the primary attack. Methods: Study conducted at Department of Ophthalmology in Out Patient Department of Mediciti Medical College Hospital, from June 2013 to December 2014. Total 30 patients’ eyes were treated with placebo treatment with antioxidants for a period of 6 months. Results: Highest prevalence of central serous retinopathy was seen in age group of 20-40 years in 26 eyes (85%), males are predominant i.e. out of 30 patients 27 (90%), risk factors of central serous retinopathy like Type A personality are observed in 3. Associated visual abnormalities like micropsia, central scotomas in 20% of patients, fluorescein angiography showed 60% inkblot pattern. After observation for 6 months visual acuity was spontaneously improved within 4-6 months in 70% of patients, recurrences was seen in 6 patients i.e. 20% is observed. Conclusions: Central serous retinopathy is most commonly seen among 20-40 years age group, with male predominance, unilateral in which Spontaneous resolution of central serous retinopathy is seen in 4-6 months so for which aggressive treatment is not necessary.

Central Serous Retinopathy in Old Age

Central serous retinopathy is a serous detachment of sensory retina in macular area resulting from retinal pigment epithelial defect. It usually affects adult between 25 and 50 years of age. Central serous retinopathy which occured in 50 years of age or older can be readily mistaken for senile macular degeneration with subretinal neovascularization, Two diseases must be differentiated because of different progress and treatment. Thirteen patients were 50 years of age or older among 172 patients with central serous retinopathy, There were 3 eyes with retinal pigment epithelial atrophy but there were no eyes with soft drusen, geographic atrophy and subretinal neovascular membrane. Subretinal neovascular membrane was not seen during follow up period also. Seven eyes received conservative treatment and 6 eyes received argon laser photocoagulation. Visual acuity of all patients improved to more than 20/50 after treatment and visual prognosis is not different with that of young adult.

Hue Discrimination and Contrast Sensitivity Deficits in Central Serous Retinopathy According to the Course of Disease

Central serous chorioretinopathy is a disease which causes decreased visual acuity and functional disturbance. As the subretinal fluid is absorbed, the visual acuity is improved but patient's complaint such as metamorphosia is remained. To assess the recovery of visual functional disturbance in response to absorption of the fluid, the hue discrimination and contrast sensitivity were tested in central serous retinopathy patients (N=30) at the first visit, first visit after the absorption of subretinal fluid, and final visit. At the first visit, there were stastically significant differences in the mean square root of total error score, blue-yellow and red-green partial error score between normal control group and central serous retinopathy group and stastically significant differences in all spatial frequency between normal group and central serous retinopathy group. First visit after the absorption of subretinal fluid, and final visit, there were stastically significant differences in the mean square root of total error score, blue-yellow and red-green partial error score between normal control group and central serous retinopathy group and stastically significant differences in mid-high spatial frequency between normal group and central serous retinopathy group.

Krypton laser treatment of central serous retinopathy.

Fourty-seven patients with central serous retinopathy analysed at Siriraj Hospital. Twenty-three eyes were treated by krypton laser photocoagulation. It was found that the duration of resolution of subretinal fluid and recovery of visual acuity was about 3-4 weeks. In most eyes, the visual acuity returned to 6/9 and 6/6. After treatment, changes in pigment at macular area and esidual symptoms such as metamorphopsia, micropsia of scotoma were found in some patients. The treatment by krypton laser photocoagulation shortens the duration of the disease but organic and functional change of the macula may be found.