Short-Term Topical Minoxidil Use Associated with Acute Central Serous Chorioretinopathy: A Case Report

Minoxidil is a topical, over-the-counter, FDA-approved drug used to treat male and female pattern hair loss. Three case reports were published associating long-term use of topical minoxidil to central serous chorioretinopathy (CSCR) after 4, 6, and 8 months of use. In this report, we will present a case of CSCR after 1 week of topical minoxidil use that resolved with discontinuation of medication and observation 6 weeks later.

A 34-year-old Hispanic male presented with a 2-week history of central visual loss and flashes in the left eye. His only medication use was 5% topical minoxidil foam for hair loss, which he had started 1 week prior to symptom onset. Ophthalmic exam revealed a round elevation of parafoveal region of the left macula with optical coherence tomography evidence of subretinal fluid and an inferior pigmented epithelial detachment, consistent with CSCR. Given recent initiation of topical minoxidil, we suspected that minoxidil may have induced CSCR. Topical minoxidil was discontinued with recommended observation. There was complete resolution of CSCR at 6-week follow-up.

Subacute, unilateral central visual loss in an otherwise healthy 34-year-old male was found to be caused by minoxidil-induced CSCR. The correlation of topical minoxidil use 1 week prior to symptom onset with resolution of findings 6 weeks after discontinuing the medication suggests CSCR as a side effect of topical minoxidil. This case report suggests that short-term use of topical minoxidil, as short as 1 week, can induce CSCR. Our case shows that minoxidil-induced CSCR can be managed with medication discontinuation and observation.