单纯疱疹性角膜炎患者血清可溶性白细胞介素2受体水平的测定

本文应用双体夹心ＥＬＩＳＡ法对４５例纯性疱疹性角膜炎（ＨＳＫ）患者血清可溶性ＩＬ－２受体（ｓＩＬ－２Ｒ）进行了研究，结果显示，活动期ＨＳＫ患者血清ｓＩＬ－２Ｒ水平显著性高于非活动期和正常对照组（Ｐ〈０．００１）；非活动期ＨＳＫ患者血清ｓＩＬ－２Ｒ水平与正常对照组相比无显著性差异（Ｐ〉０．０５）。通过对两种不同类型活动期ＨＳＫ患者血清ＨＳＫ患者血清ｓＩＬ－２Ｒ水平的比较，可见基质型明显高于上皮型（Ｐ     

HSK患者外周血T—淋巴细胞亚群与SIL—2R关系的研究

目的研究复发性单纯疱疹性角膜炎（ｈｅｒｐｅｓｓｉｍｐｌｅｘｋｅｒａｔｉｔｉｓ，ＨＳＫ）患者外周血Ｔ－淋巴细胞亚群变化与血清可溶性白细胞介素－２受体（ｓｏｌｕｂｌｅｉｎｔｅｒｌｅｕｋｉｎ－２ｒｅｃｅｐｔｏｒ，ＳＩＬ－２Ｒ）水平的关系。方法测定了３０例复发性ＨＳＫ患者外周血Ｔ－淋巴细胞亚群，同时检测血清ＳＩＬ－２Ｒ的水平并与２５例健康人做对照。结果复发性单纯疱疹性角膜炎患者ＣＤ３、ＣＤ４／ＣＤ８均值与正常对照组相比明显降低；血清ＳＩＬ－２Ｒ与对照组比较显著增高。结论复发性ＨＳＫ患者体内免疫功能低下，ＳＩＬ－２Ｒ水平升高可能是其原因之一，这也为免疫治疗提供了一定依据。     

Eales病患者血清补体免疫复合物溶解能力测定

为探讨Ｅａｌｅｓ病发病原因，我们测定了２４例患者血清补体免疫复合物溶解能力（Ｃｏｍｐｌｅｍｅｎｔｍｅｄｉａｔｅｄｉｍｍｕｎｅｃｏｍｐｌｅｘｓｏｌｕｂｉｌｉｚｉｎｇｃａｐａｃｉｔｙ，ＣＭＳＣ）。结果表明：Ｅａｌｅｓ病患者血清ＣＭＳＣ明显低于正常对照组，差异极其显著，Ｐ＜０．００１；而且发病病程短（≤１２月）与发病病程长（＞１２月）患者血清ＣＭＳＣ也有显著差异，Ｐ＜０．０１。说明该病病因很可能与免疫复合物沉积的Ⅲ型变态反应有关，为血清ＣＭＳＣ水平低下或不足所致。     

单疱病毒性角膜炎患者PBMC细胞膜白细胞介素2受体及血清可溶性白细胞介素2受体的改变

为了进一步探讨单疱病毒性角膜炎（ＨＳＫ）与免疫功能的关系，本文实验应用Ｔａｃ的单克隆抗体（ＭｃＡｂ－Ｔａｃ）间接荧光法和酶联免疫吸附实验（ＥＬＩＳＡ）夹心法，对４２例ＨＳＫ患者（包括２５例ＨＳＫ活动期患者，１７例ＨＳＫ非活动期患者），以及６０例正常献血员，作了细胞膜白细胞介素２受体（ｍＩＬ－２Ｒ）表达及血清可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平测定。结果：ＨＳＫ活动期患者的ｍＩＬ－２Ｒ及ＳＩＬ－２Ｒ测定值与ＨＳＫ非活动期患者和正常对照的相应测定值比较，差异均有显著性意义（Ｐ＜０．０１）。本文结果提示：ＨＳＫ患者ｍＩＬ－２Ｒ表达不足和ＳＩＬ－２Ｒ水平异常升高与ＨＳＫ发病及病损程度有一定的相关性。     

葡萄膜炎患者血清中可溶性白细胞介素Ⅱ受体的研究

本文采用双抗体夹心ＥＬＩＳＡ法，检测了１３例葡萄膜炎患者血清中ＳＩＬ－２Ｒ的含量，结果表明：病人组ｓＩＬ－２Ｒ为２９０．２±１６７．４ｕ／ｍｌ，对照组为１８４±２１ｕ／ｍｌ，二者相比有显著差异（Ｐ＜０．０１）。葡萄膜炎患者血清中ｓＩＬ－２Ｒ的水平明显高于正常人，说明患者的细胞免疫功能低下与ｓＩＬ－２Ｒ有密切关系。该结果提示ｓＩＬ－２Ｒ可能是通过阻断ＩＬ－２的活性，抑制ＩＬ－２介导的细胞免疫反应，造成宿主的细胞免疫功能低下，从而导致葡萄膜炎的发病。     

翼状胬肉中核糖体S6蛋白磷酸化、细胞周期蛋白D1的表达及意义

目的　研究核糖体Ｓ６蛋白磷酸化（ｒｉｂｏｓｏｍａｌＳ６ｐｒｏｔｅｉｎｐｈｏｓｐｈｏｒｙｌａｔｉｏｎ,Ｐ-Ｓ６）和细胞周期蛋白Ｄ１（ＣｙｃｌｉｎＤ１）在翼状胬肉中的表达及相关性,探讨哺乳动物雷帕霉素靶蛋白复合物１（ｍａｍｍａｌｉａｎｔａｒｇｅｔｏｆｒａｐａｍｙｃｉｎｃｏｍｐｌｅｘ１,ｍＴＯＲＣ１）信号通路在翼状胬肉发病机制中的作用。方法　收集翼状胬肉组织３１例,正常结膜组织１７例,利用免疫组织化学和Ｗｅｓｔｅｒｎｂｌｏｔ进行Ｐ-Ｓ６和ＣｙｃｌｉｎＤ１的检测及比较。结果　Ｗｅｓｔｅｒｎｂｌｏｔ检测６例翼状胬肉组织中Ｐ-Ｓ６蛋白／Ｓ６蛋白表达（１．１９６±０．１０１）显著高于正常结膜组织（０．２９５±０．０５６）,差异有统计学意义（Ｐ＜０．０５）。免疫组织化学染色结果显示:翼状胬肉中Ｐ-Ｓ６、ＣｙｃｌｉｎＤ１的阳性表达率均为１００％（２５／２５）,正常结膜组织中Ｐ-Ｓ６阳性表达率为１８．２％（２／１１）、ＣｙｃｌｉｎＤ１阳性表达率为９．１％（１／１１）,正常结膜组织与翼状胬肉组织中Ｐ-Ｓ６与ＣｙｃｌｉｎＤ１表达差异均有统计学意义（均为Ｐ＜０．０５）。翼状胬肉组织中Ｐ-Ｓ６与ＣｙｃｌｉｎＤ１的表达呈正相关（ｒ＝０．７５２,Ｐ＜０．０５）。结论　ｍＴＯＲＣ１信号通路在翼状胬肉发病过程中起重要作用,并可能通过调控ＣｙｃｌｉｎＤ１的表达来实现。     

糖尿病视网膜病变与红细胞变形能力和膜磷脂及收缩蛋白变化的关系

目的　探讨糖尿病视网膜病变（ｄｉａｂｅｔｉｃ ｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）与红细胞变形能力（ｅｒｙｔｈｒｏｃｙｔｅ ｄｅｆｏｒｍ ａｂｉｌｉｔｙ，ＥＤ）、红细胞膜磷脂成分及红细胞膜收缩蛋白（ｓｐｅｃｔｒｉｎ，ＳＰ）变化的关系。　方法　１０８例Ⅱ型糖尿病患者根据视网膜病变的有无分为ＤＲ组（５５例）和非ＤＲ（ｎｏｎｄｉａｂｅｔｉｃ ｒｅｔｉｎｏｐａｔｈｙ，ＮＤＲ）组（５３例），检测其ＥＤ、红细胞膜磷脂成分和红细胞膜收缩蛋白二聚体（ｓｐｅｃｔｒｉｎ ｄｉｍｅｒ，ＳＰＤ）、四聚体（ｓｐｅｃｔｒｉｎ ｔｅｔｒａｍ ｅｒ，ＳＰＴ）相对含量的变化。并与正常对照组５３例的相同检测结果作对比。　结果　ＤＲ患者红细胞滤过指数（ｅｒｙｔｈｒｏｃｙｔｅ ｆｉｌｔｒａｔｉｏｎ ｉｎｄｅｘ，ＥＦＩ）、ＳＰＤ、ＳＰＤ／ＳＰＴ、神经鞘磷脂（ｓｐｉｎｇｏｍ ｙｌｉｎｅ，ＳＭ）／磷脂酰胆碱（ｐｈｏｐｈａｔｉｄｙｌｃｈｏｌｉｎｅ，ＰＣ）明显增高，而ＳＰＴ、ＳＭ、ＰＣ、磷脂酰丝氨酸（ｐｈｏｐｈａｔｉｄｙｌｓｅｒｉｎｅ，ＰＳ）和磷脂酰乙醇胺（ｐｈａｔｉｄｙｌｔｈａｎｏｌａｍ ｉｎｅ，ＰＥ）明显降低，与对照组和ＮＤＲ 组比较有显著差异（Ｆ＝ ８．     

人工高眼压家兔血液,虹膜及房水cAMP,cGMP含量的关系

目的研究家兔血液、虹膜及房水中环腺苷酸（ｃｙｃｌｉｃａｄｅｎｏｓｉｎｅｍｏｎｏｐｈｏｓｐｈａｔｅ，ｃＡＭＰ）和环鸟苷酸（ｃｙｃｌｉｃｇｕａｎｏｓｉｎｅｍｏｎｏｐｈｏｓｐｈａｔｅ，ｃＧＭＰ）含量与高眼压之间的关系。方法用放射免疫方法测定家兔血浆、虹膜和房水中ｃＡＭＰ、ｃＧＭＰ含量。结果ｃＡＭＰ含量（ｎｍｏｌ／Ｌ）：血浆为７２．８１±７．６７，虹膜为１４１．０８±１６．７０，房水中为２８．４０±０．４９；ｃＧＭＰ含量（ｎｍｏｌ／Ｌ）：血浆为１０．３７±６．１５，虹膜为３５．６４±７．０２，房水中为１２．９０±０．６１。ｃＡＭＰ含量高于对照组（Ｐ＜０．０１），ｃＧＭＰ低于对照组（Ｐ＜０．０１）。结论高眼压与ｃＡＭＰ、ｃＧＭＰ含量关系显著。     

大鼠视网膜神经节细胞的培养

目的建立视网膜神经节细胞（ｒｅｔｉｎａｌｇａｎｇｌｉｏｎｃｅｌｓ,ＲＧＣｓ）的体外培养方法,为ＲＧＣｓ的体外实验研究奠定基础。方法采用胰酶消化法将１６只生后２～３天的ＳｐｒａｇｕｅＤａｗｌｅｙ大鼠视网膜制成细胞悬液后,接种于涂以鼠尾胶原的２４孔培养板,预先置入１ｃｍ×１ｃｍ的载玻片。细胞数约４×１０５个／孔,在３７℃、体积分数为５％的ＣＯ２培养箱中培养。于第１、３及５天行抗大鼠ＴＨＹ１单克隆抗体免疫细胞化学检查以鉴定ＲＧＣｓ,镜下计算每１０个高倍镜下（ｈｉｇｈｐｏｗｅｒ,ＨＰ）ＲＧＣｓ的细胞数和其轴突生长率。结果在鼠尾胶原上培养的ＲＧＣｓ生长良好,部分细胞伸出突起,且有些突起相互连接成网。培养第１天,ＲＧＣｓ数和轴突生长百分率分别为（４０１±９）个／１０ＨＰ和（２５．３４±０．７２）％,第３天为（３５１±６）个／１０ＨＰ和（３５．１６±２．２２）％,第５天为（１０９±８）个／１０ＨＰ和（６９．８４±０．９７）％。结论ＲＧＣｓ的体外培养能获成功,鼠尾胶原是ＲＧＣｓ体外生长的良好支持物。     

彩色多普勒超声对中晚期青光眼患者眼动脉血流速度的测定

目的了解中、晚期青光眼患者眼动脉血流情况及血管因素在中、晚期青光眼患者视功能损害机制中的作用。方法采用彩色多普勒超声检查仪测定１５６例中、晚期青光眼患者的眼动脉血流速度，并与正常组７５例的有关参数值进行比较。结果正常组：平均最大收缩期血流速度（ｐｅａｋｓｙｓ－ｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＰＳＶ）为３５．９８±９．１３ｃｍ／ｓ，舒张期眼动脉血流速度（ｅｎｄｄｉａｓｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＥＤＶ）为１１．９８±３．９０ｃｍ／ｓ。开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）组：ＰＳＶ为２４．１３±４．６５ｃｍ／ｓ，ＥＤＶ为７．１０±１．８５ｃｍ／ｓ，闭角型青光眼（ｐｒｉｍａｒｙｃｌｏｓｅａｎｇｌｅｇｌａｕｃｏｍａ，ＰＣＡＧ）组：ＰＳＶ为２２．８９±５．４３ｃｍ／ｓ，ＥＤＶ为７．０６±１．９２ｃｍ／ｓ。各组间ＰＳＶ与ＥＤＶ比较：ＰＯＡＧ组与ＰＣＡＧ组间差异无显著性（Ｐ＞０．０５），青光眼组与正常组间差异有非常显著性（Ｐ＜０．０１）。结论中、晚期青光眼患者因眼动脉血流速度下降明显，导致局部血液循环障碍。青光眼患者的视功能损害与视神经的血供不足关系密切。     

中心性浆液性脉络膜视网膜病变患者血浆糖皮质激素及尿类固醇 …

OBJECTIVE: To study the cortisol levels in patients with central serous chorioretinopathy (CSCR). METHODS: Endogenous cortisol levels in plasma and urine were determined in 44 patients with CSCR by radioimmunoassay and chromatography, and their results were compared with that of 41 controls. RESULTS: In acute CSCR, the mean values of the plasma cortisol (296.53 +/- 77.03) ng/ml and 24-hour urine 17-hydroxysteroids (the major metabolite of cortisol metabolism) (12.08 +/- 4.82) mg/24 h revealed significantly higher values in the patient group (P < 0.05). CONCLUSIONS: Increased levels of endogenous cortisol play a role in the development of CSCR.     

Endogenous cortisol profile in patients with central serous chorioretinopathy

AIM—To study the endogenous cortisol levels in patients with central serous chorioretinopathy (CSCR).
METHODS—Endogenous cortisol levels in urine and plasma were determined in 30 patients with acute CSCR and compared with 30 age and sex matched controls.
RESULTS—The mean values of the 8 am plasma cortisol (29.97 µg/dl v 18.76 µg/dl), 11 pm plasma cortisol (22.03 µg/dl v 13.06 µg/dl), and 24 hour urine cortisol (11.01 mg/24 h v 7.39 mg/24 h) revealed significantly higher values in the patient group (p<0.001).
CONCLUSIONS—Increased levels of endogenous cortisol are present in patients with CSCR.

     

Endocrine abnormalities in patients with central serous chorioretinopathy

PURPOSE: To investigate and to identify endocrine and metabolic abnormalities in patients with central serous chorioretinopathy (CSCR). DESIGN: Observational case series. PARTICIPANTS: Twenty-four patients with CSCR. METHODS: Serum and urinary catecholamines, glucocorticoids, mineralocorticoids, serum testosterone, and thyroid-stimulating hormone (TSH) function were evaluated prospectively. RESULTS: Fifty percent (12 of 24) of patients with active acute CSCR showed elevated 24-hour urine cortisol or tetrahydroaldosterone levels. Serum aldosterone levels were low in 7 of 24 (29.1%) patients. Single morning plasma catecholamine levels were elevated in 7 of 24 patients, although 24-hour urine metanephrines (catecholamine breakdown products) were normal. Serum testosterone and TSH levels were normal in nearly all (23 of 24) patients. CONCLUSION: Many patients with acute CSCR have elevated 24-hour urine corticosteroids, which may contribute to the pathogenesis of the disorder. Endogenous mineralocorticoid dysfunction is a newly described feature of CSCR.     

CSCR中盐皮质激素受体基因-2G/C的多态性及其与血浆皮质醇水平的关系

目的：评估中心性浆液性脉络膜视网膜(CSCR)病变中盐皮质激素受体基因-2G/ C 单核苷酸多态性,以及基因多态性和血浆皮质醇水平的关系。
　　方法：选取60例中心性浆液性脉络膜视网膜病变患者和50例正常人作为研究对象。患者皆患有急性中心性浆液性脉络膜视网膜病变,即浆液性视网膜脱离和视网膜色素上皮脱离或功能障碍(排除其它可能导致渗出的疾病,比如脉络膜新生血管、炎症或浸润病变)。为避免皮质醇水平的昼夜变化,上午8时到10时之间采集外周血样,检测盐皮质激素受体基因多态性(rs2070951)和血浆皮质醇水平。
　　结果：CSCR 组的基因型频率分布为 G/ C (46.6%), G/ G (26.7%)和 C/ C (26.7%)。两组间基因型分布无统计学差异(P=0.96)。研究结果显示,CSCR 组的血浆皮质醇水平为401.2依162.1 nmol / L ,对照组为296.8依130.1 nmol / L,两组间差异有统计学意义(P<0.01)。血浆皮质醇水平在 G/ C (345.0依137.0 nmol / L), G/ G (369.2依165.3 nmol / L)和 C/ C (395.3依188.8 nmol / L)基因型之间不存在差异(P=0.50)。
　　结论：盐皮质激素受体基因多态性与中心性浆液性脉络膜视网膜病变和血浆皮质醇水平无关。     

Serum dehydroepiandrosterone sulphate, total antioxidant capacity, and total oxidant status in central serous chorioretinopathy

Background

The objective of this work is to evaluate plasma total antioxidant capacity (TAC), total oxidant status (TOS), and dehydroepiandrosterone sulphate (DHEA-S) levels in patients diagnosed with acute central serous chorioretinopathy (CSCR) and control samples.

Methods

The TAC, TOS, and DHEA-S levels were assessed in the plasma of 46 CSCR patients and compared with 40 control samples.

Results

The TAC level was 1.16?±?0.08 and 1.20?±?0.09 mmol Trolox eq./l; TOS level was 28.77?±?33.33 and 19.95?±?10.42 μmol H₂0₂/l; DHEA-S level was 203.79?±?84.75 μg/dl and 249.36?±?122.93 μg/dl in the CSCR group and in the control group, respectively. The plasma TAC and DHEA-S values were significantly lower in the CSCR group than in the control group (p?=?0.027 and p?=?0.046, respectively). There was no significant difference between the CSCR and the control groups in terms of age, gender, and TOS levels (p?>?0.05).

Conclusions

We demonstrated that the levels of plasma DHEA-S and antioxidative parameters were reduced in CSCR. Our results suggest that the antioxidant defense system may be inadequate or corrupted in CSCR. Reduced DHEA-S level is one of the factors that trigger this insufficiency.     

Adrenocortical Adenoma and Central Serous Chorioretinopathy: A Rare Association?

A 28-year-old man with bilateral central serous chorioretinopathy (CSCR) and body weight gain was diagnosed with Cushing's syndrome secondary to an adrenocortical adenoma. The patient had high levels of free cortisol and the tumor was confirmed by histopathology. After surgery, cortisol levels decreased and the CSCR spontaneously resolved. This case highlights the role of cortisol in the pathogenesis of CSCR. A diagnosis of endogenous Cushing's syndrome should be considered in patients with CSCR as an initial symptom.     

A new potential risk factor for central serous chorioretinopathy: blood pressure variability

Background/objectivesThe choroid, mostly composed of vascular structures, can be directly affected by systemic hemodynamic changes. Blood pressure variability (BPV) may factor into choroidal dysfunction, which can be associated with the pathogenesis of central serous chorioretinopathy (CSCR). The aim of our study was to investigate short-term BPV over 24 h in patients with acute CSCR versus healthy controls.Subjects/methodsOur cross-sectional comparative study included 50 patients with CSCR (i.e., patient group) and 60 healthy individuals (i.e., control group). In all participants, 24-h ambulatory blood pressure was monitored every 15 min during the day and every 30 min at night. Mean variability index (VI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) during the day, at night, and across the 24-h period were subjected to statistical analyses.ResultsMean 24-h, daytime, and night-time SBP and DBP did not significantly differ between the groups. The mean 24-h and daytime VI values for SBP and DBP were significantly higher in the patient group than in the control group, whereas the mean night-time VI values for SBP and DBP between the groups were similar. Multivariate logistic regression models revealed that the VI values for 24-h and daytime SBP and DBP emerged as independent risk factors for developing CSCR.ConclusionOur study revealed that variabilities in 24-h, daytime SBP and DBP were significantly higher in patients with CSCR than in controls. Our results thus suggest that increased BPV may be a new risk factor for the development of CSCR.Subject terms: Risk factors, Retinal diseases     

Decreased plasma cortisol in response to intramuscular ACTH in ocular hypertensives and primary open-angle glaucomas

PURPOSE: To determine if there is a difference in response of the adrenal gland to intramuscular adrenocorticotropic hormone (ACTH) between normals and ocular hypertensives (OHs) plus primary open-angle glaucomas (POAGs) without pigmented angles. METHODS: Intramuscular ACTH was given to 29 normals and 24 OH plus POAG hospitalized in a Clinical Study Unit. Blood samples were obtained at baseline (0 hours) before administration of intramuscular ACTH and 4, 8, and 24 hours after administration of intramuscular ACTH for analysis of plasma cortisol/body mass index (BMI). RESULTS: The OH plus POAG group showed lower cortisol/BMI values compared with the normal group at 4, 8, and 24 hours with a significantly lower peak/BMI value (P=0.030). Multivariate analyses with the peak plasma cortisol/BMI level as the dependent variable showed that a lower peak plasma/BMI was associated with the OH plus POAG group. Also, a lower peak plasma cortisol/BMI level was associated with a lower 0-hour cortisol/BMI (Log). CONCLUSIONS: Compared with normals, the OH plus POAG subjects showed lower plasma cortisol levels in response to intramuscular ACTH. This observation suggests adrenal suppression in the OH plus OAG group.     

Relationship between mean platelet volume and central serous chorioretinopathy

The aim of this study was to investigate the mean platelet volume (MPV) of patients with central serous chorioretinopathy (CSCR). Thirty patients were included in the study. Thirty healthy volunteers were recruited as the control group. All patients and control subjects underwent complete ocular examination. Hemoglobin, hematocrit, white blood cell, neutrophil, lymphocyte, platelet count, and MPV of the participants were recorded. Data of patients with CSCR were compared with the control subjects. Patients with CSCR had significantly higher MPV values (9.76 ± 1.36 fL) compared with the control subjects (8.37 ± 0.72 fL) (p = 0.004). No significant difference was found in platelet counts between the CSCR group and the control group (259 ± 53.75 and 243 ± 52.11 K/Ul, p = 0.253). According to the receiver operator characteristics curve analysis, the optimal cut-off value of MPV to predict the CSCR was >9.4, with 60.0 % sensitivity and 93.3 % specificity. Our results demonstrated that the MPV values were significantly higher in patients with CSCR. MPV may be used as a predictive tool for identifying risk for CSCR.     

【In Press】 Association between endogenous cortisol level and the risk of central serous chorioretinopathy: a Meta-analysis

AIM: To assess the association between endogenous cortisol level and the risk of central serous chorioretinopathy (CSC). METHODS: Case-control studies were systematically searched on Pubmed, Embase, Cochrane, China national knowledge infrastructure (CNKI) for publishes between January 1990 and July 2017 to assess the association between endogenous cortisol level and CSC. The main endpoints were serum cortisol level at 8 am and 24-hour urine 17-hydroxysteroids level. We assessed pooled data using a random-effects model. RESULTS: Of 86 identified studies, 5 were eligible and were included in our analysis. The 5 studies included a total of 315 participants, of whom 187 had CSC. Statistically significant association was observed between serum cortisol level (summary SMD=0.77, 95%CI=0.55-0.99), 24-hour urine 17-hydroxysteroids level (summary SMD=0.95, 95%CI=0.61-1.30), and the risk of CSC. CONCLUSION: Endogenous cortisol level was associated with an increased risk of CSC. Combined treatment targeting the serum cortisol levels at 8 am and 24-hour urine 17-hydroxysteroids levels can be a potential preventive strategy for individuals who are at risk of CSC and therapeutic strategy for patients with CSC.