Corticosteroid-induced central serous chorioretinopathy

Area of Science:

• Ophthalmology
• Endocrinology

Background:

• Corticosteroids are widely used for their anti-inflammatory and immunosuppressive properties.
• However, their use has been associated with various ocular side effects.
• Central serous chorioretinopathy (CSC) and multiple posterior pigment epitheliopathy (MPPE) are conditions affecting the retina and choroid.

Observation:

• This study identified five new cases of corticosteroid-induced CSC.
• These cases, along with 28 previously reported instances, were analyzed to differentiate from idiopathic CSC.
• Nine cases of corticosteroid-induced MPPE were also reviewed for comparison.

Findings:

• Corticosteroid-induced CSC patients were generally older and less male-predominant compared to idiopathic CSC.
• MPPE cases predominantly affected female patients and often presented with bilateral involvement.
• CSC onset occurred within 70 days (short latency) or after 6 months (prolonged latency) of corticosteroid administration.
• Higher daily prednisolone doses (>20 mg) were linked to short-latency CSC, while lower doses (<20 mg) were associated with prolonged latency.
• Concurrent use of immunosuppressive agents, like cyclophosphamide, correlated with lower daily corticosteroid doses at CSC onset.

Implications:

• Distinguishing between idiopathic and corticosteroid-induced CSC is crucial for appropriate patient management.
• Understanding the latency periods and dosage effects can aid in predicting and potentially preventing corticosteroid-induced retinopathy.
• Further research is warranted to elucidate the precise mechanisms underlying corticosteroid-induced ocular pathologies.