Central serous chorioretinopathy associated with unusual routes of steroid administration

To report three cases in which unusual routes of administration were associated with subsequent central serous chorioretinopathy (CSR). All three cases occurred in patients who were being treated for dermatologic conditions.

Retrospective review of three cases of patients who presented with a diagnosis of CSR and use of steroids in an unusual route for treatment of various dermatologic conditions (intradermal injection to the scalp for keloids, topical cream for psoriasis, and topical solution for cradle cap).

Patient 1 had complete resolution and restoration of baseline visual acuity at the follow-up examination. This patient had no further injections to his keloids. Patient 2 drastically decreased the dose of topical cream and had resolution of symptoms. Patient 3 discontinued use of the steroid solution and had no new episodes of visual decline.

This case series suggests that occult steroid use should be suspected for patients presenting with CSR who are concurrently being treated for dermatologic conditions. The knowledge gained from this thorough history is vital to the management and long-term counseling of the patient.