It is a self-limiting ophthalmopathy most commonly seen in healthy middle-aged and older men (25-50 years of age) with lesions confined to the posterior pole of the fundus.
Etiology:
The occurrence of this disease is associated with mental excitement and tension, excessive mental effort, and excessive eye strain, but the exact etiology is not known. It was previously thought that impaired RPE barrier function was the main cause of this disease. However, recent observations have suggested that choroidal capillary and venous congestion and changes in vascular permeability are the main causes of the lesion, while the RPE is a secondary change.
Clinical manifestations
1. Sudden loss of visual acuity with black shadows in front of the eyes, deformation of visual objects, and small size; deformation of lines or dark spots on Amsler table examination.
2.The lesion has the tendency of self-healing, but it is easy to recur.
3, fundus examination in the macular area with varying degrees of edema, scintillation reflection, typically a dark red, round, 1 ~ 3D size slightly elevated neuroepithelial detachment area, edges with edema reflective halo, can be accompanied by some small yellow-white exudate point, the central concave light reflection disappeared.
4.Fluorescence angiography of fundus One or several small fluorescein leakage points can be seen in the macular area during the intravenous phase, with the prolongation of the imaging time, the fluorescein gradually ejects in a chimney-like manner or expands in an ink-like manner, and the dye accumulates in the neuroepithelial detachment cavity in the late phase, outlining a disc detachment area. Some patients may have detached RPE fluorescence signs. The recovery phase shows RPE pigment loss changes.
Diagnosis and differential diagnosis.
The diagnosis is not difficult to confirm based on the general middle-aged onset, the presence of triggers such as mental stress and excessive eye use before the onset, the presence of edema and yellow-white dotted exudate in the macula, and the FFA showing dye leakage, but atypical cases should be distinguished from the following eye diseases.
1, central exudative chorioretinopathy: there is hemorrhage and exudation in the macula, and FFA shows CNV leakage.
2, exudative age-related macular degeneration: older, mostly seen above 60 years old, with hemorrhage in the macula, a wider range of exudation, and faster development of CNV.
3.Acute retinal pigment epitheliitis: FFA with grape cluster-like fluorescence spots and mid-black outer bright fluorescence foci.
4, retinal detachment: involving the macular area and not scattered youhan obituary frightened map coins reeducation pay
5, ciliary retinal artery obstruction: the macular region of the optic disc has milky edema, FFA shows poor filling of the ciliary retinal artery, mostly seen in older people.
Treatment.
1, Corticosteroids are harmful to the disease and should be prohibited.
2.If the leakage point is beyond 0.5DD (or 250um) of the central macular recess, photocoagulation treatment is available.
3.Lutin, vitamin B1 and inosine and other vasodilating and nerve-nourishing drugs are available.
4.Chinese herbal medicine treatment.
5.Prohibit drinking alcohol, avoid overexertion of eyes and brain, and prevent mood swings.