How to treat the central dark spot?

summary

One of the manifestations of central serous chorioretinopathy is the enlargement of the central scotoma. Fundus fluorescein angiography (FFA) examination, dot enlargement (also known as ink diffusion type): to dye leakage point as the center to expand around

How to treat the central dark spot?

The etiology of CSC is unknown. Stress, emotional agitation, infection, allergy, choroidal venous drainage disorder, and heat regulation failure can all promote the disease. The pathogenesis of CSC may be the result of multiple factors, which is related to age, gender, blood type, climate, general condition, pregnancy, mental stress, emotional abnormality, allergy, cold, infection, etc The common predisposing factors are lack of sleep, tension, fatigue, mood swings and so on. Type a personality is prone to midplasma, which may be related to sympathetic excitation and the increase of catecholamine in blood circulation. The manifestations of experimental and aphakic maculopathy are similar to midplasma, These results suggest that the imbalance of endogenous or exogenous corticosteroids may be a pathogenic factor of plasma

The pathogenesis of plasma is not very clear. There are theories of ischemia, infection, inflammation, immune response and metabolic disorders, but there is no strong evidence. Fluorescein angiography shows that the plasma is mainly caused by the decompensation of RPE cells, which is characterized by the interruption of RPE cell continuity and dye leakage, which is the result of the destruction of RPE junction complex (barrier function), It is not RPE cell necrosis. This may be only one of the pathological damage of the disease, but not the cause of the disease. Due to the destruction of RPE cell barrier function and abnormal ion transport function, subretinal effusion is caused, resulting in macular discoid retinal detachment

In recent years, the clinical application of ICG fundus angiography found that there were not only RPE leakage changes in the plasma, but also slow filling or high perfusion of choroidal capillaries in the corresponding area, and increased permeability. It is speculated that the disease may be due to some factors leading to choroidal vasospasm or occlusion, resulting in abnormal perfusion of choroidal vessels, compensatory dilation of peripheral choroidal vessels, and increased permeability, The barrier function of retinal pigment epithelium is damaged and fluid accumulates between retinal pigment epithelium and neuroepithelium

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Experimental occlusion of choroidal capillary lobules can induce localized serous retinal detachment, which is similar to that of the middle plasma. ICGA results of some patients who were cured after laser or recovered by themselves showed that although there was no leakage point in RPE, high perfusion and high permeability still existed in choroidal lobules. Whether this phenomenon is related to recurrence remains to be further studied, The primary pathological location of the plasma should be choroidal capillaries, and the change of RPE is secondary