[Central serous chorioretinopathy and psychological stress]. / Chorioretinopathia centralis serosa und psychische Belastung.

BACKGROUND: To date we know little about the etiology of central serous chorioretinopathy. Former investigations discussed inadequate coping strategies and critical life-events as important psychological aspects. In this study we investigated the relationship between central serous chorioretinopathy and stress. MATERIALS AND METHODS: 35 male patients with central serous chorioretinopathy (group 1) were compared to 21 male patients with traumatic eye diseases. The evaluated data included sociodemographic data as well as data regarding the patients coping strategies, critical live-events before outbreak of the disease, personality factors and general physical complaints. RESULTS: Group 1 showed a significantly higher amount of general physical complaints, measured with a complaints questionnaire (B-L). In a personality inventory (FPI-R) it scored significantly higher on the scales emotional instability and strain, significantly lower on the scale extraversion. CONCLUSION: The results indicate that patients with central serous chorioretinopathy are more stressed because of inadequate coping strategies, which can be seen in a higher amount of physical complaints.

["Filtered normality": psychological causes and sequelae of specific retinal diseases]. / "Die gefilterte Normalität": Psychologische Ursachen und Folgen von spezifischen Netzhauterkrankungen.

Until now there is a lack of investigation in psychological aspects of retinopathy in patients of the middle ages. The few studies have been found, focused on an old-fashioned psychopathology. Medical treatment, f.e. laser therapy is only partially available, constant visual loss to blindness is possible. Life events, coping strategies, social support, and symptomatic distress of patients with presumed ocular histoplasmosis (group 1) and patients with retinopathy centralis serosa (group 2) were compared with another and with a comparison group. Group 1 scored higher on the Schedule of Recent Experiences (Holmes and Rahe 1967) and showed better social support. Group 2 scored higher on the Brief Symptom Inventory (Derogatis and Melisaratos 1983) and showed low social support. Additionally gender differences were discussed.

Type-A behavior and central serous chorioretinopathy.

A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type A behavioral pattern based on the Jenkins Activity Survey. The patients selected as matched controls had painless, reduced central vision and other chorioretinal diseases (Group I), or non-chorioretinal ocular conditions (Group II). The Type A behavior was significantly more frequent in study patients than in either Control Group I (X2 = 6.1 and P less than 0.025) or Control Group II patients (X2 = 17.7 and P less than 0.001). When both control groups were combined for comparison to the CSP patients, there was also a highly significant difference with regard to Type A behavior (X2 = 14.1 and P less than 0.001). A comparison of Control Group I with Control Group II revealed no significant difference in Type A behavior. Subfactor analysis of the Type A behavior pattern was also studied. The results of this clinical study were used in conjunction with experimental evidence linking catecholamines with CSP in developing a multifactorial etiologic hypothesis. The hypothesis suggests that the eyes as an organ system, and the macula as an ultimate target area, can be intermittently or continuously stimulated adversely by Type A behavior and its physiological consequences, most notably a sympathetic discharge. The multifactorial concept alludes to other potential risk factors such as age, race, sex, refractive state, or unknown tissue susceptabilities. The pathogenesis implies an inter-relationship between finely balanced components of a complex biopsychological system involving an individual's genetic endowment, his environment, and his behavioral pattern. The concept also offers new possible lines of investigation for the treatment of CSP, utilizing pharmacological regulators and for its prevention through early identification of CSP-prone individuals. A review of the pertinent cardiovasculature literature linking the Type A behavior with coronary artery disease and the significant papers in the ophthalmic literature on central serous pigment epitheliopathy are included in the discussion.

[Central serous retinopathy. Etiopathogenetic and clinical considerations (author's transl)]. / La rétinite centrale séreuse. Considérations ètiopathog éniques et cliniques.

Etiopathogenetic, clinical and therapeutic study of 24 patients affected with central serous retinopathy, hospitalized in the Ophthalmological Clinic of the University of Bari during the period 1977-1978. After reviewing the main pathogenetic theories on the disease and taking into consideration their own findings, which are also based on specific psychiatric tests, the authors conclude that central serous retinopathy probably has a psychoangiospastic etiopathogenesis.