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Central Serous Chorioretinopathy Misdiagnosed as Posterior Uveitis and the Vicious Circle of Corticosteroid Therapy

机译:中央浆液性脉络膜视网膜病变被误诊为后葡萄膜炎和皮质类固醇治疗的恶性循环

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摘要

PURPOSE: To determine the proportion of patients with central serous chorioretinopathy (CSCR) mistaken for posterior uveitis and to identify the deleterious consequences.METHODS: Charts of 1,657 patients admitted in the section of inflammatory eye diseases at the Center for Ophthalmic Specialized Care (COS) in Lausanne, Switzerland from 1995 to 2013 were reviewed. CSCR cases misdiagnosed as posterior uveitis or those with superimposed disease due to steroid therapy for uveitis were studied. Delay in diagnosis, specific erroneous uveitis diagnosis and evolution of the disease were also evaluated. Retrospectively, the most useful means for a correct diagnosis of CSCR were the original fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) when available.RESULTS: Out of a total of 1,657 patients, 15 (0.9%) cases with CSCR were identified. These included 12 subjects misdiagnosed as posterior uveitis and 3 uveitis subjects with superimposed CSCR following corticosteroid therapy for uveitis. The presentation of the disease was largely influenced by improper and continued use of corticosteroids.CONCLUSION: CSCR is a rare but not negligible misdiagnosis in posterior uveitis representing approximately 1% of subjects from a collective series of uveitis cases at a referral center. Investigative measures such as FA, ICGA and OCT are crucial for reaching a correct diagnosis and avoiding disease aggravation due to corticosteroid therapy.
机译:目的:确定被误认为是后葡萄膜炎的中央浆液性脉络膜视网膜病变(CSCR)患者的比例,并确定有害后果。方法:在眼科专业护理中心(COS)的炎性眼病科中收治的1,657名患者的病历表回顾了1995年至2013年在瑞士洛桑的研究。研究了CSCR误诊为后葡萄膜炎的病例或因类固醇治疗葡萄膜炎而合并疾病的病例。还评估了诊断的延迟,特定的错误葡萄膜炎的诊断和疾病的进展。回顾性地,正确诊断CSCR的最有用方法是使用原始的荧光血管造影(FA),吲哚菁绿血管造影(ICGA)和光学相干断层扫描(OCT)。结果:在总共1657例患者中,有15例(0.9确定了%)患有CSCR的病例。其中包括12名被误诊为后葡萄膜炎的受试者和3名在糖皮质激素治疗葡萄膜炎后叠加CSCR的葡萄膜炎受试者。该病的表现很大程度上受皮质类固醇激素使用不当和持续使用的影响。结论:CSCR是后葡萄膜炎的罕见但不能忽略的误诊,约占转诊中心一系列葡萄膜炎病例的1%。 FA,ICGA和OCT等调查措施对于正确诊断并避免由于皮质类固醇疗法引起的疾病加重至关重要。

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  • 作者

    Papadia,; Jeannin,; Herbort,;

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  • 年度 2015
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  • 原文格式 PDF
  • 正文语种 eng
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