Young and middle-aged men who often work late at night, please pay close attention! When you finish working all night, you are likely to be attacked by an eye disease “surprise”, suddenly feel a blur in front of the eyes, the center of the field of vision seems to float a black fog, and see things are distorted, shrinking. The most prevalent group of people: 25 to 50 years old men with normal vision This kind of eye disease, which is particularly targeted at young and middle-aged men who work overnight, has a lengthy name, called “idiopathic central plasma chorioretinopathy”. The frequent late nights, excessive fatigue, work tension, long-term use of corticosteroids and other factors are its triggers. According to Dr. Yi Kui Xian, deputy director of the ophthalmology department of Guangzhou General Hospital of Guangzhou Military Region, “idiopathic central plasmacytoid chorioretinopathy” mainly occurs in the macula, which is an important area of the retina, mainly related to fine vision and color vision and other visual functions. Unlike other macular lesions, this disease is most common in men between the ages of 25 and 50, with only a small percentage of men over 50 years old and very few women. Since many of the patients are senior managers of companies and enterprises or at the helm, it is also popularly known as “boss disease”. Yi Kui Xian pointed out that “idiopathic central plasmacytoid chorioretinopathy” was discovered as early as 1866, but it was generally believed to be caused by retinal vasospasm until more than 130 years later when the lesion was found to be related to pigment epithelial leakage of the retina. However, the medical community has not yet identified the true cause of the leakage of the pigment epithelium, and the pathological basis of the disease is unknown. Common symptoms: Sudden loss of vision with black shadows in front of the eyes Patients have blurred vision, black shadows in the center of the visual field, distortion and shrinkage of visual objects, and a sudden drop in visual acuity, which can be as low as 0.1. Generally, patients over the age of 50 gradually show these symptoms, but young and middle-aged men tend to have a sudden onset after staying up all night. What is even stranger is that most of the young and middle-aged patients usually have normal vision or even excellent vision. A typical example of this is a less-than-40-year-old general manager of a hotel in Guangzhou. He is a veteran, before the onset of the disease, his vision had been maintained at 2.0, but he did not expect to see a significant decline in vision overnight. Over the years, his condition is sometimes good and sometimes bad, sometimes his vision returns to normal, but as soon as he stays up late, he will immediately relapse. The main cause: stay up late overworked work stress and so on why this disease will be and stay up late working like a shadow? Yi Kui Xian said that people who stay up late at work often usually work under great pressure, life is also irregular, often overworked. In addition, when staying up all night, people are in a long period of anxiety and tension, capillaries then spasm, causing insufficient oxygen supply. Since the macular area of the eyes is the place where the whole body consumes the most oxygen, it is the first to be affected. In addition, long-term use of corticosteroid drugs can also induce the destruction of the pigment epithelial barrier. There have been cases all over China where corticosteroid treatment has been applied heavily for diseases such as nephritis and optic neuritis, resulting in the induction of central plasmacytoid retinopathy. If corticosteroids are used to treat patients who have already developed such retinopathy, their condition can also deteriorate rapidly. Many diseases have signs that precede their onset and can alert the patient. However, this particular eye disease strikes without warning, and it is difficult to find the slightest “red flag” on a routine eye exam. The extent of the lesion is not consistent with the patient’s vision, so fluoroscopic angiography is the only way to find out if the disease is active or atrophic and stable. The danger: severe cases can be near blindness Yi Kui Xian pointed out that one of the characteristics of this disease is that most patients can recover to a better level of vision without treatment, but the recurrence rate is very high. According to statistics, about 1/3 or half of the cases can recur, 10% of cases can be multiple recurrence, 50% of cases will recur only after a year or so, and even more, the disease can be temporarily “dormant” for up to 10 years. During this process, the ocular lesion gradually expands and the pigment epithelium atrophies severely. After several episodes, the neuroepithelial function declines, eventually causing permanent damage to the vision, and in severe cases, the vision is reduced to near-blindness levels. It is important to note that after the first attack, there is often an illusion of “improvement”, or a chronic extension of the disease. At this point, many patients think they have been cured or ignore the initial onset as a general loss of vision, resulting in loss of time to delay treatment. According to the introduction, “false impression” is divided into three kinds. One is that the patient’s vision progresses significantly, or even recovers. This is because the acute leakage is suspended, but in fact the scope of pigment damage continues to increase. The second is that after the condition is somewhat controlled, the patient’s vision remains good, but then suddenly returns without warning. In some cases, the patient has 3 attacks in 5 years, but the onset point is the same location. It is reported that in 80% of patients with recurrences, the onset location is within 1 mm of the initial location, while the exact 0.5 mm is found in 65% of cases. There were also patients with new onset points that had metastasized. Third, with each recurrence, the disease gets slightly worse, and visual impairment becomes difficult to recover over time, so patients with more recurrences will only see worse and worse. Because the exact cause of this particular eye disease is unknown, there is a lack of targeted and effective drug therapy. According to the report, the relatively effective treatment is to take laser treatment to stop the leakage by coalescing the light beam on the leakage point. However, photocoagulation is inherently dangerous, and the leaky spot near the central concavity is not suitable for photocoagulation, so it is not suitable for all patients. Yi Kui Xian pointed out that prevention is the only way to deal with this disease. You should maintain a regular work and rest schedule and avoid being in a state of anxiety and stress for a long time. Try to avoid frequent and continuous late nights, and if it is difficult to avoid due to work, it is best to receive regular ophthalmologic examinations. In addition, drinking alcohol and smoking can cause capillary spasm and thus should also be abstained from. Once the onset of the disease, patients should pay attention to avoid light irritation and can wear sunglasses to protect the diseased eye.