慢性中心性浆液性脉络膜视网膜病变(cCSC)以广泛的脉络膜视网膜异常为特征，包括脉络膜血管扩张及其引发的弥漫性视网膜色素上皮病变和浆液性视网膜脱离，常累及黄斑区，引起视功能损害。传统观点认为其可能由急性CSC演变而来，但近期研究显示两者在临床上存在明显差异。其病情反复、迁延，预后较差。随着光学相干断层扫描血管造影(OCTA)、超广角成像和en face重建成像等新多模式影像(MMI)技术的出现和人工智能及机器学习的发展，更多有意义的cCSC影像学特征不断出现。文章详细介绍了cCSC在眼底成像、眼底自发荧光(FAF)、光学相干断层扫描(OCT)、眼底荧光素血管造影(FFA)、吲哚菁绿血管造影和OCTA等影像技术中的表现，并探讨了人工智能在识别CSC分类及其OCT 生物标志物等方面的应用。不同影像技术在cCSC的诊断和研究中各有优势，如FAF可能是评估疾病进展及变化的有效手段，OCT可更直观地观察视网膜结构的改变，FFA是识别渗漏点的重要检查手段，而OCTA可能是评估脉络膜微循环的的最佳手段等。这些MMI研究进展为深入了解cCSC的病理生理机制及临床特征提供了重要线索，有助于提高诊断的准确性和效率，改善患者的预后和生活质量。

Chronic central serous chorioretinopathy (cCSC) is characterized by extensive retinochoroidal abnormalities. This includes difuse retinal pigment epitheliopathy and serous retinal detachment associated with choroidal vasodilatation, ofen involving the macula and cause visual impairment. It was originally considered that it might evolve from acute CSC, but recent studies have shown significant clinical differences between the two. It tends to recur, be prolonged, and have an unfavorable prognosis. With the advent of new multimodal imaging (MMI) techniques such as optical coherence tomography angiography (OCTA), ultra-wide-feld imaging, and en face reconstruction imaging, along with the advancement of artificial intelligence and machine learning, more significant cCSC imaging characteristics have been constantly emerging. Tis article provides a comprehensive overview of cCSC’s imaging features across various modalities, including fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), fuorescein angiography (FFA), indocyanine green angiography, and OCTA. It also explores the application of artifcial intelligence in identifying CSC classifications and OCT biomarkers. Different imaging techniques have their own advantages in the diagnosis and study of cCSC, such as FAF being an efective means to assess disease progression and changes, OCT providing a more intuitive observation of retinal structural changes, FFA being an important tool for identifying leakage points, and OCTA possibly being the best means to assess choroidal microcirculation. Tese MMI research advancements ofer crucial insights for clinicians, aiding in more accurate diagnosis and efective treatment, thereby potentially improving patient outcomes and quality of life.

Background: To report the outcomes of external drainage of subretinal fluid (SRF) in exudative retinal detachment secondary to central serous chorioretinopathy (CSCR).

Methods: Retrospective observational analysis of six eyes with exudative retinal detachment secondary to CSCR who underwent external drainage of SRF between 2004 and 2014 was performed. Collected data included demographics, steroid usage, surgical details, and visual acuity preoperatively and postoperative visual acuity and clinical examination data were collected.

Results: Six eyes of six subjects were included with mean age of 45 years (range, 32 to 61 years). All subjects were male. Mean duration of symptoms was 4.6 months (range, 3 to 8 months). The pre-operative bestcorrected visual acuity (BCVA) ranged from perception of light to 20/60. Four eyes were treated with conventional external drainage and two underwent Chandelier-assisted external drainage. Three cases had laser treatment before drainage and one case underwent photodynamic therapy (PDT) after drainage. The BCVA at last follow-up ranged from 20/2,000 (counting fingers at 2 feet) to 20/20. No recurrences were noted in any of the cases till the last follow-up. Mean duration of follow-up was 38 months.

Conclusions: Our study demonstrates successful management of exudative retinal detachment secondary to CSCR with external SRF drainage without any complications.

Background: To report the outcomes of external drainage of subretinal fluid (SRF) in exudative retinal detachment secondary to central serous chorioretinopathy (CSCR).

Methods: Retrospective observational analysis of six eyes with exudative retinal detachment secondary to CSCR who underwent external drainage of SRF between 2004 and 2014 was performed. Collected data included demographics, steroid usage, surgical details, and visual acuity preoperatively and postoperative visual acuity and clinical examination data were collected.

Results: Six eyes of six subjects were included with mean age of 45 years (range, 32 to 61 years). All subjects were male. Mean duration of symptoms was 4.6 months (range, 3 to 8 months). The pre-operative bestcorrected visual acuity (BCVA) ranged from perception of light to 20/60. Four eyes were treated with conventional external drainage and two underwent Chandelier-assisted external drainage. Three cases had laser treatment before drainage and one case underwent photodynamic therapy (PDT) after drainage. The BCVA at last follow-up ranged from 20/2,000 (counting fingers at 2 feet) to 20/20. No recurrences were noted in any of the cases till the last follow-up. Mean duration of follow-up was 38 months.

Conclusions: Our study demonstrates successful management of exudative retinal detachment secondary to CSCR with external SRF drainage without any complications.

Background: To find the changes of macular perimetry (MP) and the correlations between MP and best correct visual acuity (BCVA) in different phases of the acute central serous chorioretinopathy (CSC).

Methods: Twenty-one eyes with acute CSC and their fellow eyes were analysed retrospectively. MP at 2°, 4° and BCVA in the active and resolved phase were collected and analyzed. The differences of these parameters in CSC eyes and fellow eyes were analyzed. Spearman correlation was used for analysis of correlation between MP and BCVA.

Results: From 29 eyes with CSC analysed 27eyes (93.10%) recovered to the previous VA. Compared with the active phase, MP at 2°, 4° and BCVA were significantly improved in the resolved phase(P=0.000, 0.000, 0.000, respectively). MP at 2°, 4° and BCVA of CSC eyes were significantly poor compared with the fellow eyes in the active phase (P=0.000, 0.000, 0.000, respectively). In the resolved phase there was no significant difference between the CSC eyes and fellow eyes (P=0.339, 0.141, 0.161, respectively). BCVA was shown to significantly correlate with MP at 2° in the active phase (ρ=–0.630, P<0.001).

Conclusions: The acute CSC often had a good prognosis both in BCVA and MP. MP can provide an additional objective parameter to evaluate the retinal function changes at macula of acute CSC. 

Background: To find the changes of macular perimetry (MP) and the correlations between MP and best correct visual acuity (BCVA) in different phases of the acute central serous chorioretinopathy (CSC).

Methods: Twenty-one eyes with acute CSC and their fellow eyes were analysed retrospectively. MP at 2°, 4° and BCVA in the active and resolved phase were collected and analyzed. The differences of these parameters in CSC eyes and fellow eyes were analyzed. Spearman correlation was used for analysis of correlation between MP and BCVA.

Results: From 29 eyes with CSC analysed 27eyes (93.10%) recovered to the previous VA. Compared with the active phase, MP at 2°, 4° and BCVA were significantly improved in the resolved phase(P=0.000, 0.000, 0.000, respectively). MP at 2°, 4° and BCVA of CSC eyes were significantly poor compared with the fellow eyes in the active phase (P=0.000, 0.000, 0.000, respectively). In the resolved phase there was no significant difference between the CSC eyes and fellow eyes (P=0.339, 0.141, 0.161, respectively). BCVA was shown to significantly correlate with MP at 2° in the active phase (ρ=–0.630, P<0.001).

Conclusions: The acute CSC often had a good prognosis both in BCVA and MP. MP can provide an additional objective parameter to evaluate the retinal function changes at macula of acute CSC. 

目的：观察急性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)的自然病程中渗漏点的形态及变化。方法：本研究为前瞻性研究，使用光学相干断层扫描(optical coherence tomography，OCT)观察从发病到发病后5~13个月的CSC患者的渗漏点的OCT形态，测量并计算Hall层、脉络膜全层各自厚度及比值，并进行比较。结果：共20例患者[男14例，女6例，年龄33~59(中位数41)岁]纳入研究。随访时间为5~13个月。在19例患者中观察到微小视网膜色素上皮脱离(pigment epithelium detachment，PED)。1例患者可见视网膜色素上皮(retinal pigment epithelium， RPE)小凸起。在随访期间，仅1例患者的PED完全恢复，其他19例患者在视网膜下液被完全吸收时，RPE和Bruch膜之间仍存在微小分离。渗漏点处的Haller层/脉络膜厚度显著高于中央凹处(初诊时0.806±0.08 vs 0.863±0.06，P=0.003；最后1次随访时为0.801±0.07 vs 0.851±0.06，P=0.004)。结论：本研究观察到在急性CSC患者自然病程中，即使视网膜下液吸收，OCT显示渗漏点处仍存在持续的PED，更厚的Haller层及更薄的内层脉络膜，这些发现为CSC的发病机制提供了更多线索。

Objective: To observe the morphology and changes of leakage points in the natural course of acute central serous chorioretinopathy (CSC). Methods: This study was a prospective study, using optical coherence tomography to observe the OCT morphology of leakage points in CSC patients from onset to 5 to 13 months after onset, measuring the thickness and ratio of Hall layer and the whole choroid, and then compare them. Results: A total of 20 patients were included in the study, including 14 males and 6 females, aged from 33 to 59, with the median being 41 years old. The follow-up time ranged from 5 months to 13 months. Minute retinal pigment epithelial detachments (PED) were observed in 19 patients. A small bulge of retinal pigment epithelium (RPE) was observed in 1 patient. During the follow-up, only one patient totally recovered. Small separation between RPE and Bruch membrane still exit even subretinal fluid were absorbed completely in the other 19 patients. The thickness of Haller layer or choroid at the leakage point was significantly higher than that of the fovea (0.806±0.08 vs 0.863±0.06, P=0.003, at the first visit; 0.801±0.07 vs 0.851±0.06, P=0.004, at the last follow-up). Conclusion: This study observed that in the natural course of acute CSC patients, even if the subretinal fluid was absorbed, OCT still showed that there was persistent PED at the leakage point, thicker Haller layer and thinner inner choroid layer. These findings provided more clues to the pathogenesis of CSC.

幽门螺杆菌(Helicobacter pylori，H P)感染是中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)的一个危险因素，但是在HP感染和CSC相关性的研究仍存在争议，目前有两种观点：一是认为HP感染可能是CSC的一个危险因素，二是认为两者之间并没有相关性。本文将就对HP感染是否为CSC危险因素文献进行综述，同时探讨其发病机制。

Helicobacter pylori (HP) infection is a risk factor for central serous chorioretinopathy (CSC). But the existing studies tend to support two distinctively different trends regarding the link between HP infection and CSC. The first group tend to support that: HP infection may be a risk of CSC, and the second tend to claim to no correlation between the two. This paper will review the literature on whether HP infection is a risk factor for CSC and discuss its pathogenesis.