Central serous chorioretinopathy associated with high-dose follistatin-344: a retrospective case series

To present 11 bodybuilding athletes who developed central serous chorioretinopathy (CSCR) following high-dose subcutaneous follistatin-344, a peptide-based performance and image enhancing drug, injections to increase muscle mass.

This is a retrospective case series from one institution. Demographic and clinical data of 11 patients who were admitted to our clinic with decreased visual acuity after high-dose follistatin-344 injections and optical coherence tomography (OCT) findings consistent with CSCR were analyzed.

All 11 patients were male, and the mean age was 36.8 ± 8.1 years. All patients had a history of injecting complete 1 mg vials of follistatin-344 subcutaneously in the abdomen. There was a history of a single previous high-dose follistatin-344 injection in eight patients and multiple previous injections in three patients. At the time of diagnosis, ten patients had unilateral CSCR findings and one had bilateral CSCR findings. In all eight patients with a history of only one injection, subretinal fluid completely disappeared after an average of 2.3 ± 0.7 months and symptoms regressed. Recurrent CSCR developed in three patients with a history of multiple follistatin-344 injections.

Follistatin-344 injection can be considered as a risk factor for CSCR. To take medical history from CSCR patients including follistatin-344 use may be important to reveal the CSCR etiology.