Corticosteroids and central serous chorioretinopathy.
ABSTRACT The purpose of this study is to investigate the relationship between corticosteroid use and central serous chorioretinopathy (CSC).
A prospective, case-controlled study.
A consecutive series of patients with acute manifestations of CSC and a control group matched for age, race, and gender were recruited between January 2000 and July 2000.
A detailed clinical history was taken, and fundus examination with slit-lamp biomicroscopy was performed on all patients. Fluorescein angiography was obtained on the study patients.
A total of 50 patients was recruited. Twenty-six patients (52%) had a history of exogenous steroid use, including oral, intravenous, intranasal, and intraarticular administration. Two additional patients had a history of endogenous hypercortisolism (Cushing's syndrome). In a matched control group, eight patients (18%) had a history of steroid use. The difference in corticosteroid exposure between study patients and controls was statistically significant (P < 0.0001).
History of corticosteroid use or Cushing's syndrome.
This study is consistent with previous reports associating steroid use with CSC. It identifies corticosteroids as a significant risk factor for the development of acute, exudative macular manifestation and implicates hypercortisolism as a factor in the pathogenesis of this disorder. Several forms of corticosteroid administration were observed to be a risk factor for CSC. Accordingly, susceptible patients in need of corticosteroids should be advised of the risk of developing acute manifestations of CSC.
SourceAvailable from: Haoyu Chen[Show abstract] [Hide abstract]
ABSTRACT: Background Acute Vogt-Koyanagi-Harada (VKH) disease and acute central serous chorioretinopathy (CSCR) are two common disorders with serous retinal detachment caused by dysfunction of choroid. The purpose of this study is to compare the morphological changes of these two diseases with spectral domain optical coherence tomography (SD-OCT). Methods In this retrospective comparative study, the SD-OCT images of 65 eyes with acute VKH and 52 eyes with acute CSCR were reviewed for the presence of subretinal fluid, folds of retinal pigment epithelial (RPE), fluctuation of internal limiting membrane (ILM), subretinal septa, retinal pigment epithelium detachment (PED) and bulge of RPE. The foveal thickness was measured using the manual caliper of OCT software. The characteristics of SD-OCT were compared between two diseases. Results Subretinal fluid was present in both diseases. Folds of RPE, fluctuation of ILM, subretinal septa were seen only in VKH. Bulge of RPE presented only in CSCR. PED was more common in CSCR than in VKH (44.2% vs 3.1%, p < 0.001). The thickness of fovea and RPE undulation index were significantly greater in VKH compared to that in CSCR (746.7 ± 423.8 vs 444.9 ± 158.8 μm, p < 0.001 and 1.0667 ± 0.0509 vs. 1.0177 ± 0.0023, p = 0.003). Conclusion Our study showed that although VKH and CSCR share similar features on SDOCT, there are characteristic differences between both disease entities.BMC Ophthalmology 06/2014; 14(1):87. DOI:10.1186/1471-2415-14-87 · 1.08 Impact Factor
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ABSTRACT: Ziel dieser Studie war es, bei Patienten mit Chorioretinopathia centralis serosa (CCS) Netzhautfunktion und -morphologie mittels Fundusperimetrie und OCT zu vergleichen.Bei 14 Augen von 14 Patienten mit einseitiger, erstmalig aufgetretener CCS wurde sowohl eine funduskontrollierte Perimetrie mit dem Microperimeter 1 (MP1) als auch eine OCT-Untersuchung durchgeführt. Analysiert wurde die Netzhautdicke ebenso wie die Lichtunterschiedsempfindlichkeit (LUE) im korrespondierenden Gesichtsfeld.Bei allen Patienten bestand eine seröse Abhebung der zentralen neurosensorischen Retina mit einer maximalen Netzhautdicke von 381±82 m. In der Fundusperimetrie zeigte sich ein mittlerer Defekt von 8,3±3,8 dB, der gut mit der Netzhautdicke korrelierte (r=0,73). Ebenso korrelierte die jeweils maximale Netzhautdicke gut mit der LUE im korrespondierenden Gesichtsfeldareal (r=−0,58).Das MP1 ermöglicht eine Quantifizierung funktioneller Ausfälle bei CCS. Obwohl die Sehschärfe im Durchschnitt nur geringfügig reduziert war, zeigten alle Patienten in der Mikroperimetrie ausgedehnte Skotome, die gut mit der Netzhautdicke korrelierten.Der Ophthalmologe 01/2006; 103(9). · 0.72 Impact Factor
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ABSTRACT: We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management.Middle East African journal of ophthalmology 10/2014; 21(4):354-7. DOI:10.4103/0974-9233.142279