Atlas of Ophthalmology

Idiopathic Central Serous Chorioretinopathy (Fluorescence Angiography, SD-OCT, Colour Image)

Retina -> Aquired Macular Diseases
Patient: 38 years of age, male, BCVA 0.8, IOP 15 mmHg. Ocular Medical History: decrease of vision, curved lines. General Medical History: empty. Main Complaint: curved lines. Purpose: to show serous detachment of the neurosensory retina in the macular region in idiopathic central serous chorioretinopathy . Methods: Fluorescence Angiography, SD-OCT(Heidelberg Engineering), Colour Image. Findings: Fluorescence Angiography: Fluorescein angiography at 37 sec , the early phase shows a hyperfluorescent spot due to leakage of dye through the RPE. The distance between the hyperfluorescent spot and the foveola is about 1.4 mm. SD-OCT:Optical coherence tomography image showing separation of the sensory retina from the retinal pigment epithelium. Colour Image: regular macula. Discussion: Idiopathic central serous chorioretinopathy (ICSCR) is characterized by a serous detachment of the neurosensory retina in the macular region. ICSCR affects the vision to different degrees. The pathophysiology of ICSCR is not clear and there is no effective treatment. Several potential risk factors have been elucidated. One of the factors that has more frequently been associated with ICSCR is stress. A possible association between Helicobacter pylori infection and eye diseases, including Sjögren syndrome, blepharitis, central serous chorioretinopathy and uveitis, has been proposed. Izzotti et al. (1) and Mateo-Montoya et al. (2) suggested, that H. pylori was identified as a possible etiological factor in ICSCR. H pylori infection may influence the pathophysiology of ICSCR by releasing various proinflammatory and vasoactive substances, as well as by influencing the apoptotic process. Systemic H pylori-induced oxidative damage may be the mechanism which links oxidative stress. Literature: (1) Izzotti A, Saccà SC, Bagnis A, Recupero SM. Glaucoma and Helicobacter pylori infection: correlations and controversies. Br J Ophthalmol. 2009 Nov;93(11):1420-7. doi: 10.1136/bjo.2008.150409. (2) Mateo-Montoya A, Mauget-Faÿse M. Helicobacter pylori as a risk factor for central serous chorioretinopathy: Literature review. World J Gastrointest Pathophysiol. 2014 Aug 15;5(3):355-8. doi: 10.4291/wjgp.v5.i3.355.

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