Combined central serous chorioretinopathy, hypermetropia, short axial length, chorioretinal folds, enlarged/thickened ocular coats, with varying association of scleral changes (CHAFES)

BMC Ophthalmology

Case Report

Sonia P Mall¹  Andrew Gibson²  Rasmeet Chadha³  Saoud Al-Khuzaei⁴  Susan M Downes⁴  Victor Chong⁵  Alan C. Bird⁶ 

[1] Ashford and St Peter’s Hospitals NHS Foundation Trust, Ashford, UK;James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK;Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford Eye Hospital,, West Wing LG1, Headley Way, OX3 9DU, Oxfordshire, England, UK;Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford Eye Hospital,, West Wing LG1, Headley Way, OX3 9DU, Oxfordshire, England, UK;Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK;UCL Institute of Ophthalmology, Bath Street, EC1V 9EL, London, UK;UCL Institute of Ophthalmology, Bath Street, EC1V 9EL, London, UK;Moorfields Eye Hospital, City Road, EC1V 2PD, London, UK;

关键词: Central Serous Chorioretinopathy (CSC);    Chronic;    Choroidal folds;    Chorioretinal folds;    Posterior pole flattening;    Ocular coats thickening;    T-Sign;    Hypermetropia;    Short axial length;   

DOI  :  10.1186/s12886-023-03038-5

 received in 2023-04-07, accepted in 2023-06-12,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeTo describe a condition with the following features: chronic central serous chorioretinopathy (CCSC), chorioretinal folds, scleral changes (including any of the following flattened or ‘squared off’ posterior pole, ‘T sign’, or thickened ocular coats), accompanied by a short axial length and hypermetropia in a series of 7 patients.MethodsThe case notes of 7 patients presenting with a combination of CSC, choroidal folds scleral changes and hypermetropia were reviewed as part of a retrospective case series. Corrected visual acuities, serial refraction, colour imaging, fluorescein and indocyanine green angiography findings, together with B-ultrasound scan features were recorded, with axial length measurements as available (< 23.3 mm was defined as short).ResultsThe study included 14 eyes of 7 subjects (2 females and 5 males) with a primary presentation of central vision disturbance. All patients showed signs of previous or current episodes of the following features in at least one eye: CSC (5/7 bilateral); choroidal folds (6/7 bilateral), thickening of ocular coats in the 5 in whom this was measured, at least one scleral abnormality on ultrasound in at least one eye. A short axial length at final appointment was recorded in 13/14 eyes.Conclusions and relevanceThe combination of CCSC with choroidal folds, hypermetropia with apparent shortening of the eyeball associated with one or more scleral abnormalities such as a flattened or ‘squared off ‘appearance of the B ultrasound may be a specific ocular condition. The aetiology of this particular combination of posterior segment manifestations is unknown; the choroid could be the primary focus of disease with secondary involvement of the sclera. Alternatively, the features observed may result from a chronic inflammatory process affecting the sclera with secondary effects on the choroid, retinal pigment epithelium and retina. In our case series, the final vision was not significantly different from vision at presentation.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3

Fig. 1

41116_2023_38_Article_IEq331.gif

41116_2023_38_Article_IEq302.gif

41116_2023_38_Article_IEq262.gif

41116_2023_38_Article_IEq229.gif