TESTOSTERONE-INDUCED CENTRAL SEROUS CHORIORETINOPATHY MIMICKING A CHOROIDAL MASS

The purpose of this study was to describe a case of supplemental testosterone-induced central serous chorioretinopathy (CSCR) mimicking a choroidal mass in a 63-year-old man.

This is a case report on a 63-year-old male patient on self-prescribed supplemental testosterone with CSCR mimicking a choroidal mass.

A 63-year-old man presented with new-onset vision loss, subretinal fluid, and choroidal mass in his left eye. IV fluorescein angiography showed an enhancing choroidal mass involving the fovea. B-scan ultrasonography revealed diffuse choroidal thickening. Given concern for a diffuse uveal melanoma, the lesion was biopsied showing nondiagnostic rare, atypical melanocytes. Four months after initial presentation, the patient was diagnosed with polycythemia vera. Fourteen months after diagnosis, he admitted to testosterone supplementation. On cessation of the testosterone supplement, the lesion progressively flattened to a chorioretinal scar with subretinal fluid resolution and returned to normal choroidal thickness over the next 14 months.

Testosterone supplementation has been linked to erythrocytosis and polycythemia vera. In the retina, testosterone supplementation has been linked to CSCR and both central and branch retinal artery and vein occlusions. This case report demonstrates the importance of inquiring about all prescribed and over-the-counter medications in patients presenting with retinal lesions of unknown origin.