Central serous chorioretinopathy and glucocorticoids: an update on evidence for association

Central serous chorioretinopathy is a common idiopathic retinal disease characterized by central vision loss from serous detachment of the neurosensory retina, serous pigment epithelial detachments, and leakage of fluid through the retinal pigment epithelium into the subretinal space. The concept of an association between exogenous glucocorticoid use and central serous chorioretinopathy is widely accepted among ophthalmologists. Here, we review the evidence for and against such an association. This evidence includes 2 large, case-control studies that found strong associations, and a smaller, population-based study that found no association. We conclude that the preponderance of the literature on this topic supports the existence of an association. Both exogenous and endogenous glucocorticoids have been implicated. Although a mechanism and a causal relationship remain to be established, the association deserves broader recognition among physicians who prescribe glucocorticoids.