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Intravitreal steroid-associated central serous chorioretinopathy
Shreyas Temkar1, Goutham Rajasekar2, Shruti Nair2
1Ophthalmology, JIPMER, Puducherry, India shreyastemkar@gmail.com.
BMJ Case Reports
|January 8, 2025
Summary
Intravitreal steroid injections may cause central serous chorioretinopathy (CSC), a condition affecting vision. Doctors should monitor patients for increased neurosensory detachment after these treatments.
Area of Science:
- Ophthalmology
- Retinal diseases
Background:
- Central serous chorioretinopathy (CSC) is a recognized adverse effect of systemic steroid use.
- The potential for intravitreal steroids to induce CSC remains debated in clinical practice.
Observation:
- Two patients developed acute CSC following intravitreal steroid injections for diabetic macular edema and branch retinal vein occlusion-related macular edema.
- Initial treatment with intravitreal triamcinolone acetonide resolved cystoid edema but led to progressive neurosensory detachment (NSD).
Findings:
- Fundus fluorescein angiography confirmed CSC in both cases.
- Focal laser therapy and oral eplerenone successfully resolved NSD in the respective patients.
- The findings support a causal link between intravitreal steroids and acute CSC.
Implications:
- Clinicians should maintain a high index of suspicion for CSC when NSD progresses after intravitreal steroid administration.
- This evidence suggests a need for careful consideration of intravitreal steroid use and vigilant monitoring for CSC development.
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