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Donatella Musetti, Massimo Nicolo, Carlo Traverso; CENTRAL SEROUS CHORIORETINOPATHY IN WOMEN. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3842.
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To describe the clinical features of central serous chorioretinopathy (CSC) in women by Optical Coherence Tomography (OCT), Fluorescein angiography (FA) and Indocyanine green angiography (ICG). To evaluate preliminary results of different types of treatment
Prospective cross-sectional study. Twenty-seven eyes from 22 women (19 Caucasians and 3 Hispanics) with active CSC were included in the study. Inclusion criteria were the presence of a neurosensory retinal detachment of the macula (NSRD) and/or a pigment epithelial detachment (PED) as detected by OCT examination together with reduced visual acuity (VA). The fellow eyes of each patient were classified as normal when they showed physiological retinal profiles and VA was normal. Historical factors and medical records of each patient were evaluated. Subjects were divided into three groups based on three different treatment options: photocoagulation, photodynamic therapy (half doses, HD or half fluence ,HF) or no treatment (complete spontaneous recovery), respectively.
CSC was associated with steroid use in 10 patients, while it was idiopathic in the other 12. Five patients reported no associated medical condition, 5 reported hypertension as their only medical condition, 3 unspecified autoimmune disease, 2 hyperthyroidism, 1 asthma, 1 organ transplant and 7 were heavy smokers. The most frequent symptoms were decreased VA and metamorphopsia. Seventeen eyes had a NSRD alone, whereas another 5 eyes had an associated PED. Two eyes were treated by argon laser photocoagulation; 14 eyes with photodynamic therapy (10 HD and 4 HF) and 6 recovered spontaneously. With a follow up of 2 years, both laser treatment and photodynamic therapy (PDT) yielded similar results with a trend for the HD-PDT treated patients to perform better. Mean age of onset in women was 50 ± 9.7 (mean ± SD) years, later than that reported in literature for men
Although predominantly found in men, our study shows that CSC in women has similar features and similar response to treatment . As steroids were used by a significant number of study subjects, the cortisol may play a role in the development of CSC in women. The mechanism by which other causes influence the development of CSC is worth further investigations.
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