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Abstract: This patient came to our hospital with 2 days of visual distortion in the right eye. After visual acuity, fundus examination, optical coherence tomography and fundus fluorescence angiography, the diagnosis was: central plasmacytoid chorioretinopathy of the right eye. After 3 months, the patient’s visual distortion disappeared and healed.
Basic information】Male, 40 years old
Disease Type】Central plasmacytoid chorioretinopathy
Hospital】The First Hospital of Harbin Medical University
Date of Consultation】August 2021
Treatment plan】Oral medication (vitamin B complex tablets, vitamin C tablets)
Treatment Period】3 months of outpatient treatment
Effectiveness】The condition was controlled and the patient’s visual distortion disappeared.
I. Initial consultation
The patient was 40 years old, and his first visit to our hospital was with the complaint of “visual distortion in the right eye for 2 days”. The patient reported: 2 days ago, he suddenly developed a deformation of vision in his right eye, with straight lines turning into curved ones, not accompanied by eye redness, eye pain, dizziness, nausea, vomiting and other symptoms. The patient was asked whether there were any other causes before the disease. The patient reported that he was particularly busy at work before the disease, often staying up late at night working, getting anxious and getting angry, and his health condition was poor, and his blood pressure was also higher than usual.
Examination: right eye corrected visual acuity 0.6, left eye corrected visual acuity 1.0, no obvious abnormalities in the anterior segment of both eyes. Fundus examination of the right eye revealed a disc-shaped plasma retinal superficial detachment area of about 3 PD in the macula with loss of central concave reflection, while the fundus of the left eye was approximately normal. The optical coherence tomography (OCT) examination suggested a limited plasma retinal neurosuperior endothelial detachment in the macula of the right eye. Fundus fluorescence angiography (FFA) suggested that fluorescence leakage like cooking smoke was seen in the macula of the right eye.
All the above findings supported the diagnosis of central plasmacytoid chorioretinopathy in the right eye.
II. Treatment history
It is still believed that central plasmacytoid chorioretinopathy is a self-limiting disease, and most patients can heal spontaneously in 3-6 months. Remove systemic triggers, stop smoking and drinking, do not overexert yourself, take oral vitamin B complex tablets and vitamin C tablets, and review regularly. We communicated with the patients and their families, explained to them the self-healing nature of central plasmacytoid chorioretinopathy, and that most of the patients could recover their central vision to the pre-sickness level with a better prognosis, relieved the tension of the patients and their families, and told them the impact of improving lifestyle and reducing stress on the course and prognosis of the disease.
III. Treatment effect
At the review after 2 weeks of treatment, the patient’s symptoms of self-perceived visual distortion were relieved, and the anxiety of the patient and family members was significantly relieved after communication with the patient. The patient’s anxiety was significantly relieved after communication with the patient and his family. The patient showed significant improvement at the 1-month and 2-month check-ups. At the 3rd month review, the patient described that the visual distortion symptoms completely disappeared. The optical coherence tomography (OCT) examination also indicated that the macular area of the right eye was approximately normal. The patient and his family felt very satisfied with this treatment and were advised to review the patient regularly and to consult the patient at any time if there was any change in his condition.
IV. Notes
I was very pleased to be able to help the patient recover his health. After the treatment cycle, I advised the patient to continue to maintain a healthy lifestyle, keep good habits and avoid staying up late and working hard. Adjust your mind and relieve the stress in your life and work. Daily diet with more high vitamin foods, such as fresh fruits, vegetables, animal offal, etc., will also help the recovery of the disease, and try to avoid spicy and stimulating foods. Inform patients and their families that central plasmacytoid chorioretinopathy also has the possibility of recurrence, and instruct patients to review their condition regularly and seek medical attention at any time if the condition changes. The patient was advised to lead a healthy life, exercise in moderation, and improve their immune system to reduce the chance of recurrence of the disease.
V. Personal insight
Central plasmacytochoroidal retinopathy is a common choroidal retinopathy whose etiology and pathogenesis are not yet clear, mostly seen in young adults aged 20-45 years old, with a significantly higher prevalence in men than in women. Central plasmacytoid chorioretinopathy is prone to recurrence and is self-healing. The current age group of 20-45 years old is burdened with great stress in life and work. It is recommended to maintain a healthy lifestyle despite the heavy work and life, quit smoking and drinking, do not overwork, and find ways to relieve self-stress. Most patients can heal themselves in 3-6 months, and most of them can fully recover their central vision after recovery to the pre-sickness, so the prognosis is better, even if they have the disease, they should not be overly nervous and anxious, so as to facilitate the recovery of the disease.