Misdiagnosis of Atypical Chronic Central Serous Chorioretinopathy

HUANG Lijuan; PENG Suyin; LIU Binquan; DENG Zhixiang; WANG Xiuqin; ZHANG Qiuli

doi:10.3969/j.issn.1002-3429.2024.20.002

Abstract：Objective To discuss the clinical features of Cushing's syndrome complicated with chronic central serous chorioretinopathy(CSCR)and the causes of misdiagnosis.Methods The clinical data of a patient with Cushing's syndrome and chronic CSCR misdiagnosed as choroiditis were retrospectively analyzed.Results A 36-year-old obese female,with a history of depression and hypertension,was diagnosed with left choroiditis by specialized physical examination,laser fundus scanning,optical coherence tomography,fundus autofluorescence and fluorescein fundus angiography due to decreased visual acuity in her left eye for 1 year and aggravation for 2 months.After the injection of triamcinolone acetonide in the left eye,ad-ministration of Esculin and Digitalisglycosides Eye Drops into the left eye and the oral administration of Xuemingmu tablets,the symptoms did not improve significantly.After indocyanine green angiography(ICGA),the patient was diagnosed as chro-nic CSCR in both eyes in January 2023 at an ophthalmic center,and underwent bilateral retinal laser photocoagulation.She was diagnosed with Cushing's syndrome and right adrenal cortical adenoma(ACA)by relevant examinations.At 10-month fol-low-up after adrenalectomy for ACA the visual acuity showed certain improvement.Conclusion Cushing's syndrome compli-cated with atypical chronic CSCR is rare,and it is prone to misdiagnosis if merely local ocular symptoms are emphasized and systemic symptoms are ignored.It is necessary to strengthen the understanding of chronic CSCR,timely update and consoli-date the relevant theoretical knowledge,and improve the ability to distinguish between various fundus diseases,so as to ensure early detection,early diagnosis,and early diagnosis.