{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:34:29Z","timestamp":1785429269458,"version":"3.56.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T00:00:00Z","timestamp":1461283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe 4 patients who were diagnosed with chronic central serous chorioretinopathy (cCSC), which appeared to be the presenting symptom of Cushing syndrome (CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective review of charts, all patients received extensive ophthalmologic examination and endocrinologic analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 56-year-old man and a 49-year-old woman were treated because of bilaterally active, therapy-resistant cCSC. The clinical sign indicative for CS leading to referral to the endocrinologist was muscle weakness in the man and plethora in the woman. In a 37-year-old woman with known diabetes mellitus and central obesity, bilateral cCSC was diagnosed before CS screening. Another 49-year-old woman was treated for unilateral cCSC for 4 years. Complaints of fatigue, muscle weakness, central adiposity, and skin atrophy led to referral and a CS diagnosis due to bilateral macronodular adrenal hyperplasia. In all patients, CS surgery resulted in complete resolution of subretinal fluid. During postsurgical follow-up, no reactivation of cCSC was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic CSC can be the principal manifestation of relatively mildly symptomatic and unrecognized CS. In patients with cCSC, ophthalmologists should have a high index of suspicion for clinical signs of CS that warrant endocrinologic analysis. Cushing syndrome surgery can stop active subretinal fluid leakage in cCSC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5301\/ejo.5000790","type":"journal-article","created":{"date-parts":[[2016,5,2]],"date-time":"2016-05-02T04:52:03Z","timestamp":1462164723000},"page":"442-448","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":32,"title":["Chronic Central Serous Chorioretinopathy as a Presenting Symptom of Cushing Syndrome"],"prefix":"10.1177","volume":"26","author":[{"given":"Elon H.C.","family":"van Dijk","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Leiden - The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greet","family":"Dijkman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Leiden - The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke R.","family":"Biermasz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors, Leiden University Medical Center, Leiden - 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