helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2021-14-3-65-72helmholtzeyeinstitute-720Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУFOR OPHTHALMOLOGY PRACTITIONERSЦентральная серозная хориоретинопатия у пациентов с увеитом после кортикостероидной терапии: шесть клинических случаевCentral serous chorioretinopathy in uveitis patients after corticosteroid therapy: a report of 6 casesСкворцоваН. А.SkvortsovaN. A.

 врач-офтальмолог 

ул. 2-я Владимирская, д. 2, стр. 2, Москва, 111123, Россия

ул. Шарль-Моннар, д. 6, 1003, Лозанна, Швейцария

 MD 

2 bld., 2, Vladimirskaya str., Moscow, 111123, Russia

Rue Charles-Monnard 6, 1003 Lausanne, Switzerland

nat.skvortsova@gmail.comПапасаввасИ.PapasavvasI.

 врач-офтальмолог 

ул. Шарль-Моннар, д. 6, 1003, Лозанна, Швейцария

 FEBOphth 

Rue Charles-Monnard 6, 1003 Lausanne, Switzerland

ХербортК. П.Herbort JrC. P.

 д-р медицины, профессор 

ул. Шарль-Моннар, д. 6, 1003, Лозанна, Швейцария

 MD, PD 

Rue Charles-Monnard 6, 1003 Lausanne, Switzerland

cph@herbortuveitis.chЦентр диагностики и хирургии заднего отдела глаза; Центр специализированной офтальмологической помощи, отделение воспалительной и ретинальной патологииРоссияPosterior Eye Segment Diagnostics and Surgery Center; Inflammatory and Retinal Eye Diseases, Centre for Ophthalmic Specialised careRussian FederationЦентр специализированной офтальмологической помощи, отделение воспалительной и ретинальной патологииШвейцарияInflammatory and Retinal Eye Diseases, Centre for Ophthalmic Specialised careSwitzerland2021120920211436572Copyright © Скворцова Н.А., Папасаввас И., Херборт К.П., 20212021Скворцова Н.А., Папасаввас И., Херборт К.П.Skvortsova N.A., Papasavvas I., Herbort Jr C.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/720

Цель работы – описать случаи центральной серозной хориоретинопатии (ЦСХР) у пациентов с увеитом.

Материал и методы

Материал и методы. Представлен ретроспективный анализ, а также офтальмологические и системные особенности пациентов с увеитом, наблюдавшихся в период 20-летней работы Центра специализированной офтальмологической помощи в Лозанне (Швейцария).

Результаты

Результаты. Из 1793 пациентов с увеитом, наблюдавшихся в Центре, у 6 (0,3 %) после кортикостероидной терапии этого заболевания развилась ЦСХР. Средний возраст пациентов составлял 40 ± 13,4 года, возникновение заболевания не имело связи с полом. У всех 6 пациентов выявлялись клинические признаки ЦСХР на одном глазу и субклинические на парном. Средняя продолжительность кортикостероидной терапии перед развитием ЦСХР составляла 4,95 ± 4,0 месяцев. Средняя максимально корригированная острота зрения на момент ЦСХР составляла 0,6 ± 0,26 и 0,8 ± 0,17 после прекращения кортикостероидной терапии. В 3 глазах наблюдалась соответственно нейросенсорная отслойка сетчатки и отслойка пигментного эпителия. В 6 глазах из 10 при флюоресцентной ангиографии выявлено фокальное просачивание красителя и зоны повреждения ретинального пигментного эпителия. Во всех глазах отмечена диффузная гиперфлюоресценция хориоидальных сосудов, выявленная с помощью ангиографии с индоцианином зеленым.

Заключение

Заключение. При функциональном и морфологическом ухудшении у пациентов с увеитом, получающих кортикостероидную терапию, без признаков реактивации воспаления следует подозревать ЦСХР. Это крайне редкое, но серьезное осложнение, требующее незамедлительного снижения дозы и отмены кортикостероидов.

Purpose

Purpose. To report central serous chorioretinopathy (CSCR) in uveitis patients.

Material and methods

Material and methods. A retrospective chart review of uveitis patients seen in a time frame of 20 years at the Centre for Ophthalmic Specialised Care, Lausanne, Switzerland. The ophthalmic and systemic features are presented.

Results

Results. Out of 1793 uveitis patients followed at the Centre for Ophthalmic Specialised Care, 6 patients (0.3%) developed CSСR following corticosteroid therapy due to uveitis. The mean age of patients was 40 ± 13.4 years, disease incidence was not associated with gender. In all 6 patients’ clinical disease was unilateral but subclinical signs were present in all fellow eyes. The mean duration of corticosteroid therapy before CSCR had occurred was 4.95 ± 4.0 months. The mean best-corrected visual acuity at the moment of CSCR was 0.6 ± 0.26 and 0.8 ± 0.17 after discontinuation of corticosteroids. Neurosensory retinal detachment and pigment epithelium detachment were observed in 3 eyes, respectively. During fluorescein angiography (FA), focal dye leakage and areas of alteration of RPE were observed in 6 out of 10 eyes. Diffuse hyperfluorescence of choroidal vessels observed by ICGA was detected in all eyes.

Conclusion

Conclusion. Central serous chorioretinopathy should be suspected when functional and morphological deterioration occurs in uveitis patients receiving corticosteroid therapy with no signs of inflammation reactivation. This complication is extremely rare but serious condition which needs a prompt tapering and discontinuing of corticosteroids.

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The authors declare that there are no conflicts of interest present.