According to Dr. Boon, visual acuity can be preserved
in many conditions associated with macular subretinal fluid accumulation.
“This is because the choroid provides 90% of all the oxygen requirements of macular photoreceptors,” he said.
“Another possible explanation is that the closed compartment may allow a reasonable level of molecular exchange.
Furthermore, cones have fewer oxygen needs than rods, and the fovea may receive oxygen from the perifoveal capillary plexus when detached from the underlying choroid,” he explained.
“In addition, cones are more resistant to damage than rods, as seen in the atrophic variant of age-related macular degeneration (AMD),
where the rod-rich areas degenerate earlier in the disease process ลาวสามัคคี วีไอพี.
There is the possibility of an alternative visual cycle in which cones have been shown to recycle visual pigment intra-retinally through the Muller cells.”
Dr. Boon noted that these factors support the observation that visual acuity can be preserved in many macular subretinal fluid accumulation cases.
Looking to the bright future The exact pathogenesis remains unknown in some of the diseases that are part of the differential
diagnosis of serous maculopathy, such as CSC, MEK inhibitor-associated retinopathy (MEKAR),
optic pit, tilted disc with inferior staphyloma, serous maculopathy with absence of retinal pigment epithelium (SMARPE),
serous maculopathy due to aspecific choroidopathy (SMACH),
and serous retinal detachments that occur in Waldenstrom macroglobulinemia.
“A thorough insight into genetic and other risk factors of these diseases is crucial to unraveling their pathogenesis especially in the diseases with high, unmet medical needs,” explained
Dr. Boon. According to him, each of these conditions can be distinguished diagnostically from CSC using the appropriate clinical tools and ophthalmological examinations.
Indeed, even a basic ophthalmological work-up using fundoscopy and optical coherence tomography (OCT)
can already provide important clues regarding the correct diagnosis.
And additional imaging tests such as fundus autofluorescence (FAF), fluorescein angiography (FA),
and indocyanine green angiography (ICGA) can be considered for obtaining a clearer clinical picture.
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