The role of psychological stress and the hypothalamic pituitary adrenal axis in the pathophysiology of central serous chorioretinopathy
10.3969/j.issn.1672-5123.2009.05.001
- VernacularTitle:精神压力在中心性浆液性脉络膜视网膜病变病因学中的作用
- Author:
Chun-Mei, LI
;
Chang-Xian, YI
- Publication Type:Journal Article
- Keywords:
psychological stress;
central serous chorioretinopathy;
hypothalamic-pituitary-adrenal system;
glucocorticoids
- From:
International Eye Science
2009;9(5):809-811
- CountryChina
- Language:Chinese
-
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 is 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.
