Ekzojen Kortikosteroide Bağlı Santral Seröz Koryoretinopatide Retinal ve Koroidal Değişiklikler

Öz

Bu çalışmanın amacı ekzojen steroid kullanımına bağlı santral seröz koryoretinopati (SSKR) ile idiyopatik SSKR’li gözlerde retinal ve koroidal bulguları karşılaştırmaktır. Bu retrospektif çalışmada Ocak 2017 – Ocak 2020 tarihleri arasında steroide bağlı SSKR (Grup I) ve idiyopatik SSKR (Grup II) tanısı alan olguların demografik ve klinik özellikleri karşılaştırılmıştır. Tüm hastaların en iyi düzeltilmiş görme keskinlikleri kaydedilmiştir. En fazla 3 ay süreyle semptomu olan ve tanı anında optik koherens tomografi (OKT) yapılmış olan olgular çalışmaya dahil edilmiştir. İki grubun santral makula kalınlığı (SMK), subretinal mayi (SRM) yüksekliği, pigment epitel dekolmanı (PED) yüksekliği ve subfoveal koroid kalınlığı (SFKK) karşılaştırılmıştır. PED varlığı, PED ve SRM ilişkisi, subretinal hiperreflektif materyal varlığı, fotoreseptör uzaması, elipsoid zon hasarı, intraretinal ödem, koroidal ve retinal hiperreflektif noktalar, sığ irregüler PED gibi OKT bulguları kaydedilmiştir. Grup I 17 olgunun 23 gözünü, grup II 22 olgunun 23 gözünü içerdi. Her iki grupta da erkek cinsiyet baskındı (p=0,458). İki grup arasında ortalama yaş açısından farklılık yoktu. Grup I’de bilateral tutulum daha fazlaydı (p=0,030). İki grup arasında SMK, SRM yüksekliği ve PED yüksekliği açısından anlamlı farklılık yoktu ancak ortalama SFKK grup I’de grup II’den daha fazlaydı (p=0,046). PED sayısı grup I’de grup II’den anlamlı olarak daha fazlaydı (p=0,042). Diğer OKT bulguları iki grupta benzer oranlardaydı. Steroide bağlı SSKR’li gözlerde, ortalama subfoveal koroid kalınlığı ve PED sayısı idiyopatik SSKR’li gözlerden daha fazladır. Ekzojen kortikosteroidlerin hem koroid dolaşımını hem de retina pigment epitelini etkileyerek SSKR’ye neden olabilecekleri düşünülmüştür.

Anahtar Kelimeler

• kortikosteroid
• optik koherens tomografi
• retina pigment epiteli
• santral seröz koryoretinopati
• subfoveal koroid kalınlığı

Retinal and Choroidal Changes in Exogenous Corticosteroid Associated Central Serous Chorioretinopathy

Öz

The aim of this study is to compare retinal and choroidal findings in eyes with exogenous steroid induced central serous chorioretinopathy (CSCR) and idiopathic CSCR. In this retrospective study, demographic and clinical characteristics of patients diagnosed with steroid-induced CSCR (Group I) and idiopathic CSCR (Group II) between January 2017 and January 2020 were compared. Best corrected visual acuity of all patients were recorded. Cases who were symptomatic for up to 3 months and who had optical coherence tomography (OCT) images were included to the study. Central macular thickness (CMT), the heights of subretinal fluid (SRF) and pigment epithelial detachment (PED) and subfoveal choroidal thickness (SFCT) were compared between the two groups. Presence of PED, association between PED and SRF, sub-retinal hyperreflective material, photoreceptor elongation, ellipsoid zone damage, intraretinal edema, choroidal and retinal hyperreflective dots and flat irregular PED were recorded. Group I included 23 eyes of 17 cases and group II included 23 eyes of 22 cases. Male gender was dominant in both groups (p=0,458). There was no significant difference in terms of age between the two groups. Bilaterality was higher in Group I (p=0,030). Although there was no significant difference in CMT and the height of SRF and PED, mean SFCT was higher in group I than group II (p=0,046). Number of PEDs was significantly higher in group I than group II. Other OCT features were similar in two groups. Subfoveal choroidal thickness and number of PEDs is higher in steroid-induced CSCR than idiopathic CSCR. Exogenous steroids may cause CSCR by affecting both choroidal circulation and retinal pigment epithelium.

Anahtar Kelimeler

• central serous chorioretinopathy
• corticosteroid
• optical coherence tomography
• retinal pigment epithelium
• subfoveal choroidal thickness

Kaynakça

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