Chorioretinopathy

Systemic glucocorticoid treatment can cause severe exacerbation of bullous exudative retinal detachment and lasting visual loss in some patients with idiopathic central serous chorioretinopathy (SEDA-20, 374 68). The atypical presentation of this condition can include peripheral retinal capillary nonperfusion and retinal neovascularization. The treatment of choice in patients with idiopathic central serous chorioretinopathy is laser photocoagulation. 

In a prospective, case-control study 38 consecutive patients (28 men and 10 women), aged 28-63 years with central serous chorioretinopathy, were compared with 38 age- and sex-matched controls (28 men and 10 women) aged 27-65 years (69). Eleven patients (29% eight men and three women) with central serous chorioretinopathy were taking glucocorticoids, compared with two patients (5.2% one man and one woman) in the control group (OR = 7.33, 95% Cl = 1.49, 36). 

Subtenon local injection of a glucocorticoid is effective in the treatment of certain forms of uveitis. Central serous chorioretinopathy, confirmed by optical coherence tomography, developed after a single local subtenon glucocorticoid injection to treat HLA-B27-associated iritis (70). 

Two patients developed central serous chorioretinopathy after prolonged treatment with glucocorticoids applied locally to the skin (427). 

Gass JD, Little H. Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy. Ophthalmology 1995 102(5) 737 I7. 

Karadimas P, Bouzas EA. Glucocorticoid use represents a risk factor for central serous chorioretinopathy a prospective, case-control study. Graefe s Arch Clin Exp Ophthalmol 2004 242 800-2. 

Baumal CR, Martidis A, Truong SN. Central serous chorioretinopathy associated with periocular corticosteroid injection treatment for HLA-B27-associated iritis. Arch Ophthalmol 2004 122 926-8. 

Karadimas P, Kapetanios A, Bouzas EA. Central serous chorioretinopathy after local application of glucocorticoids for skin disorders. Arch Ophthalmol 2004 122 784-6. 

Meredith TA, Aaberg TM, Willerson WD. Progressive chorioretinopathy after receiving thioridazine. Arch Ophthalmol 1978 96(7) 1172-6. 

Guyer DR, Yannuzzi LA, Slakter JS, et al. Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 1994 112 1057-1062. 

The use of inhaled steroids has been associated with the development of central serous chorioretinopathy. In susceptible patients the systemic absorption of inhaled steroids may be sufficient to induce macular detachment and reduced central visual acuity associated with central serous chorioretinopathy. 

Haimovici R, Gragoudas ES, Duker JS, et al. Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids. Ophthalmology 1997 104 1653-1660. 

Possible" effects (all possibly due to the associated activity and not the drug) mydriasis, retinal vascular accidents, subconjunctival hemorrhages, anterior ischemic optic neuropathy (NAION), central serous chorioretinopathy (CSCR)... 

Nielsen, J.S., Weinreb, R.N., Yannuzzi, L. and Jampol, L.M. (2007) Mifepristone treatment of chronic central serous chorioretinopathy. Retina, 27, 119-122. 

Subjects with LCHAD and TFP deficiency who maintained lower hydroxyacylcamitines had significantly better vision and slower progression of chorioretinopathy over 5 years of follow-up [15]. In addition, patients who had fewer episodes of metabolic decompensation and fewer hospitalizations also had better vision and slower progression of retinopathy [23]. 

Fig. 23.3 Chorioretinopathy associated with LCHAD deficiency, (a) Retinal photo of a normal eye (b) retinal photo of a child with early LCHADD retinopathy. Note the dark peppery clumping in the center of the eye and the white area to the left, (c) Retinal photo of a child with late-stage LCHADD retinopathy. The white areas represent part of the retina where the photoreceptors and...

Homozygous or heterozygous for c. 1528G>C Areflexia on neurologic exam Chorioretinopathy of LCHADD... 

Coleman H, Chew E (2007) Nutritional supplementation in age-related macular degeneration. CurrOpin Ophthalmol 18 220-223. doi 10.1097/ICU.0b013e32814a586b Mares-Perlman JA, Fisher AI, Klein R, Block G, Millen AE, Wright JD (2001) Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. Am J Epidemiol 153 424—432 Sasamoto Y, Gomi F, Sawa M, Tsujikawa M, Hamasaki T (2010) Macular pigment optical density in central serous chorioretinopathy. Invest Ophthalmol Vis Sci 51 5219-5225. doi 10.1167/iovs.09-4881... 

Sensory systems Eyes Half-fluence verfe-porfin photodynamic therapy (300 mW/cm light intensity) for central serous chorioretinopathy is generally regarded as safer than full-fluence photodynamic therapy (600 mW/cm light intensity). However, in one case a pigment epithelial tear occurred after half-fluence verteporfin photodynamic therapy in central serous chorioretinopathy [20" ]. 

The two main adverse reactions to intravitreal inserts of sustained-release glucocorticoids are cataracts and increased intraocular pressure [31 ]. Glucocorticoids can also be associated with central serous chorioretinopathy or exacerbation of existing chorioretinopathy, a disorder that is characterized by serous detachment of the neurosensory retina at the posterior pole of the fundus. Central serous chorioretinopathy has been reported in a 42-year-old... 

Chan W-M, Lai TYY, Lai RYK, Liu DTL, Lam DSC. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy one-year results of a randomized controlled trial Ophthalmology 2008 115 1756-65. 

Kim SW, Oh J, Oh IK, Huh K. Retinal pigment epithelial tear after half fluence PDT for serous pigment epithelial detachment in central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging 2009 40 300-3. 

Kocabora MS, Durmaz S, Kandemir N. Exacerbation of central serous chorioretinopathy following intravitreal triamcinolone injection. Graefes Arch Clin Exp Ophthalmol 2008 246 1783-6. 

Stefaniotou M, Vourda E, Katsanos A, Aspiotis M. Multifocal central serous chorioretinopathy associated with steroids in a patient with... 

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