CSC继发脉络膜新生血管研究进展

Research progress of choroidal neovascularization secondary to central serous chorioretinopathy

中心性浆液性脉络膜视网膜病变(CSC)是一类以黄斑区视网膜神经上皮层浆液性脱离为特征的自限性疾病。CSC可继发脉络膜新生血管(CNV),造成视力预后不良。近年来研究表明,病程是CSC继发CNV主要的危险因素,其发生机制尚未完全阐明,可能涉及脉络膜局部缺血缺氧及视网膜屏障功能受损等多种病理机制。多模态影像技术有助于诊断CSC继发的CNV,光学相干断层扫描示高反射扁平不规则色素上皮脱离需要高度警惕继发CNV的可能。虽然尚未有统一标准的治疗方案,大量研究提示光动力疗法和玻璃体腔注射抗血管内皮生长因子药物可改善此类患者视力预后。本文综述了CSC继发CNV的危险因素、发病机制、多模态影像诊断模式、治疗等方面的研究进展,以期为临床早期诊断和治疗提供参考。

Central serous chorioretinopathy(CSC)is a self-limiting disease characterized by serous detachment of the neurosensory retina affecting the macular area.Choroidal neovascularization(CNV)is a common complication of CSC which would lead to a poor visual prognosis.Recent studies have shown that disease duration is a main important risk factor for CNV secondary to CSC.Although the mechanism is not fully understood,it may involve various pathological mechanisms including choroidal ischemia and hypoxia and impaired retinal barrier function.Multimodal imaging techniques can improve the detection rate of CNV secondary to CSC,while optical coherence tomography showing hyperreflective flat irregular pigment epithelial detachment requires high vigilance for the possibility of secondary CNV.The utilization of photodynamic therapy and anti-vascular endothelial growth factor drugs improves its visual prognosis,but it still lacks consensus on treatment regimen.This article reviews the research progress in risk factors,pathogenesis,multimodal imaging for diagnosis and treatment of CNV secondary to CSC to help better understand the mechanism of CNV formation and optimize the clinical management of such situation.