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Elon H.C. Van Dijk, Michiel Nijhoff, Eiko de Jong, Onno Meijer, Aiko De Vries, Camiel J F Boon; Central serous chorioretinopathy in primary hyperaldosteronism. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5343.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the ophthalmological characteristics of 13 patients with primary hyperaldosteronism (PA).
Prospective cohort study. All patients underwent an extensive ophthalmological examination.
Thirteen PA patients (9 male, 4 female) were diagnosed with arterial hypertension for 11.0 ± 11.2 years. Ophthalmological imaging revealed macular serous subretinal fluid (SRF) on optical coherence tomography (OCT) in 2 patients (15%). In one of these patients bilateral chronic central serous chorioretinopathy (CSC) with polypoidal choroidal neovasculopathy was diagnosed, which was effectively treated with full-dose photodynamic therapy. In the other patient with bilateral diffuse hyperfluorescent areas on fluorescein angiography, the SRF decreased spontaneously after 6 weeks of follow-up. In 5 of the remaining patients (38%) retinal pigment epithelium alterations resembling findings in CSC and/or pachychoroid pigment epitheliopathy were seen on multimodal imaging. The mean subfoveal choroidal thickness was 290.2 ± 65.0 μm.
Retinal abnormalities resembling (subclinical) CSC may be common in patients with PA. These findings may indicate that mineralocorticoid-mediated pathways are involved in the pathogenesis of CSC. A diagnosis of PA should be considered in CSC patients with hypertension of unknown origin.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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