Role of psychological stress and the hypothalamicpituitary -adrenal axis in the pathophysiology of central serous chorioretinopathy
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National Natural Science Foundation of China (No.30600695/C030309)

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    Abstract:

    Central serous chorioretinopathy (CSC) is characterized by serous detachment of the sensory retina as a consequence of the focal leakage of fluid from the choriocapillaries to subretinal space through a defect of the retinal pigment epithelium (RPE). The exact cause of CSC has not well unknown. Psychological stress is thought to contribute to CSC, but the physiologic mechanisms are unclear. It is hypothesized that psychological stress can induce CSC through the mechanism of the hypothalamic-pituitary-adrenal (HPA) system. Psychological stress can adversely affect HPA axis and causes glucocorticoid levels to elevate. Increased glucocorticoids constrict choroid vessels, which leads to ischemia of choroids and damage vascular endothelial cells, thus causing vasopermeability to increase. RPE dysfunction will occur as a result of abnormalities in the choroidal circulation. The large molecules including protein may enter the subretinal space through the damaged vessels and RPE.

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Chun-Mei Li, Chang-Xian Yi. Role of psychological stress and the hypothalamicpituitary -adrenal axis in the pathophysiology of central serous chorioretinopathy. Int J Ophthalmol, 2009,2(4):283-285

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  • Received:September 25,2009
  • Revised:October 28,2009
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