Autonomic dysfunction in patients with central serous chorioretinopathy

Bezerra, Fernanda Machado; Castro, Emerson Fernandes de Sousa e; Andrade, Fábio Mendonça Xavier; Irigoyen, Maria Cláudia

doi:10.5935/0034-7280.20180070

Cited by 1 publication

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“…[ 5 86 ] In addition, blood pressure variability and significantly reduced spontaneous baroreflex function are described in CSC. [ 87 88 ] The arterial wall of blood vessels is more susceptible to intermittent stress than to continuous stress as may be brought about by multiple risk factors working synergistically or sequentially. [ 88 ]…”

Section: Cardiovascular Diseases and Central Serous Chorioretinopathymentioning

confidence: 99%

Central serous chorioretinopathy: Pathophysiology, systemic associations, and a novel etiological classification

Jain¹,

Mohan

Dijk

2022

Taiwan J Ophthalmol

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Central serous chorioretinopathy (CSC) has remained an enigmatic disease since its initial description by Von Graefe. Over the years, multiple risk factors have been recognized: these include psychological stress, behavioral traits, and corticosteroids. The basic pathophysiology of CSC involves choroidal thickening, vascular congestion, altered choroidal blood flow (ChBF), and choroidal hyperpermeability, leading to retinal pigment epithelium decompensation and subsequent neurosensory detachment. Multiple organ systems, mainly the nervous, cardiovascular, endocrinal, and renal systems participate in the control of the vascular tone and the ChBF via hypothalamus–pituitary–adrenal axis and renin–angiotensin–aldosterone system, while others such as the hepatic system regulate the enzymatic degradation of corticosteroids. Many vasoactive and psychotropic drugs also modulate the ocular perfusion. In addition, there are anatomical and genetic predispositions that determine its progression to the chronic or recurrent form, through cellular response and angiogenesis. We herein review the basic pathophysiology and immunogenetics in CSC along with the role of multiple organ systems. With this background, we propose an etiological classification that should provide a framework for customized therapeutic interventions.

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