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中心性浆液性脉络膜视网膜病变,简称中浆,是指由于视网膜色素上皮缺陷导致液体从脉络膜毛细血管局灶性渗出,引起视网膜神经感觉层浆液性脱离的一组疾病。确切的病因还不清楚,虽然眼科学者一直认为精神压力与中浆的发生有着密切的关系,但中浆发生的病理生理学机制还不清楚。在本文中我们提出一种假设,认为精神压力通过下丘脑-垂体-肾上腺(HPA)系统诱发中浆的发生。精神压力能增加HPA系统活性,从而引起糖皮质激素水平相应增高。增高的糖皮质激素收缩脉络膜血管,导致脉络膜缺血和血管内皮损伤,血管渗透性增加。视网膜色素上皮血液供应来源于脉络膜,脉络膜血液循环异常也将引起色素上皮功能障碍。血液中大分子蛋白进入视网膜下间隙,导致视网膜下积液,视网膜脱离。
Central serous chorioretinopathy, referred to as pulp, refers to the retinal pigment epithelium defects due to focal leakage of fluid from the choriocapillaris, causing a group of retinal neurosensory serous detachment of a group of diseases. The exact etiology is unclear. Although ophthalmologists have always believed that mental stress is closely related to the occurrence of pulp, the pathophysiology of the pulp is unknown. In this paper, we propose a hypothesis that mental stress induces the formation of pulp through the hypothalamic-pituitary-adrenal (HPA) system. Mental stress can increase HPA system activity, resulting in a corresponding increase in glucocorticoid levels. Increased glucocorticoids constrict choroidal blood vessels, leading to choroidal ischemia and vascular endothelial injury, with increased vascular permeability. Retinal pigment epithelial blood supply from the choroid, choroidal blood circulation abnormalities will also cause pigment epithelial dysfunction. Large blood protein molecules into the subretinal space, resulting in subretinal fluid, retinal detachment.