center dark spot enlargement
Introduction
Introduction One of the manifestations of central serous chorioretinopathy is the expansion of the central dark spot. Fluorescein fundus angiography, dot enlargement (also known as ink-dispersion type): expands around the point where the dye leaks. Common causes are lack of sleep, stress, fatigue, mood swings and so on. Type A personality is prone to meditation, which may be related to sympathetic excitation and elevated catecholamines in the blood circulation. Experimental adrenaline macular degeneration and aphakic epinephrine macular degeneration showed similar performance to eucommia. Clinically, seroderma occurs in young men and menopausal women, as well as in some Cushing's lesions and pregnancy, all of which suggest that endogenous or exogenous corticosteroid imbalance may be a cause of serotonin.
Cause
Cause
(1) Causes of the disease
The real cause is unknown, mental stress, emotional agitation, infection, allergy, choroidal venous drainage disorder, and thermal regulation failure can all contribute to the disease. Middle sera (CSC) may be the result of multiple factors, and its incidence is related to age, gender, blood type, climate, general condition, pregnancy, mental stress, mood abnormalities, allergies, colds, infection, excessive fatigue and alcohol and tobacco stimulation. . Common causes are lack of sleep, stress, fatigue, mood swings and so on. Type A personality is prone to meditation, which may be related to sympathetic excitation and elevated catecholamines in the blood circulation. Experimental adrenaline macular degeneration and aphakic epinephrine macular degeneration showed similar performance to eucommia. Clinically, seroderma occurs in young men and menopausal women, as well as in some Cushing's lesions and pregnancy, all of which suggest that endogenous or exogenous corticosteroid imbalance may be a cause of serotonin.
(two) pathogenesis
The pathogenesis of cytoplasm is not well understood, and there are such studies as ischemia, infection, inflammation, immune response and metabolic disorders, but there is no strong evidence. Fluorescence angiography showed that the middle pulp was mainly decompensated by RPE cells, which showed continuous interruption of RPE cells and dye leakage. This is the result of the destruction of the barrier function of the RPE-linked complex, not the necrosis of RPE cells. This may be only one of the pathological lesions of the lesion, and it is not the cause of the disease. Due to the abnormal function of RPE cell barrier function and the function of transporting ions, the subretinal effusion is caused, and the discoid retinal detachment is formed in the macular area.
Examine
an examination
Related inspection
Ophthalmic examination of the eye and sacral area CT examination
1 dot enlargement type (also known as ink stain dispersion type): it is expanded around the point of dye leakage, the most common, accounting for 70% to 80%.
2 spray type (also known as smoke type): it is smoke-like, which is caused by the formation of a disc-shaped fluorescent pool in the subretinal space of the late FFA dye, which accounts for 10% to 20%.
3 atypical leakage point type: the lesion is often cluster-like distribution, showing a fluorescent staining point and/or a window-like defect or a vitreous-like fluorescent bright spot on the periphery of the bright central black, the leakage is not obvious or very slow, without accompanying Discoid serous retinal detachment is more common in chronic recurrent, subacute or convalescent cases.
There may be more than one leakage point in the same eye. The above three types of leakage can also exist at the same time, both appear after the fluorescing venous phase, and only a few occur in the arterial phase. This is the medullary and choroidal neovascular membrane. One of the important identification points, the latter's leakage time is in the early stage of the artery.
Diagnosis
Differential diagnosis
Central dark spot or arcuate dark spot: multiple visual white point syndrome visual field examination can be seen in the dark point of the bow, the dark side of the center or the dark spot of the center. Most patients complain of sudden loss of vision and flashing sensation, and some patients may have dark spots of vision. The range of vision loss can range from 1.0 to 0.05, but mostly mild to moderate. The anterior segment examination is normal. Many white spotted lesions can be seen in the fundus examination. They are located in the deep layer of the retina and RPE. They are mostly distributed in the posterior pole and the macula near the vascular arch, but do not invade the fovea. The lesions near the equator are few and sparse. Typical lesions are approximately circular, unequal in size, 100-500 m, light in color and blurred in borders, much like photo-condensation spots formed by low-power lasers on the retina. Fine pigment particles are often seen in the central recess. In some cases, the disc boundary is unclear. In the acute phase, there are a few cells in the vitreous. In a few cases, vascular white sheath formation is observed.
The central dark spot and the change of diopter: the malicment melanoma of uvea is the most common malignant intraocular tumor in adults. Its incidence in foreign countries accounts for the first place in the eye, especially in China. Second only to retinoblastoma, the second place in the intraocular tumor. The tumor has a high degree of malignancy and is easily metastasized to blood flow. It is more common in adults and is easily confused with many fundus diseases in clinical work. Therefore, it should be given full attention in the clinical work of ophthalmology. The disease is more than middle-aged patients. The posterior pole of the eye is a good site, and the incidence rate is decreasing in the forward direction.
