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Dipal Shah, Ronni M Lieberman; Recurrent Central Serous Chorioretinopathy with Steroids. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1797.
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To determine if a subset of patients with central serous chorioretinopathy (CSCR) secondary to exogenous steroid use have anatomic and functional resolution of their symptoms after steroids are discontinued and to evaluate whether their symptoms recur. To determine if once resolved, the neurosensory detachment recurred without the exogenous steroid and to examine the role of treatment in these cases.
Retrospective chart review of 40 patients seen between January 2013 and October 2014 with CSCR was conducted. Patients who initially developed CSCR while on steroids were evaluated. Data from these patients was reviewed for demographics, systemic disease, route of steroid administration, initial best corrected visual acuity (BCVA), and initial optical coherence tomography (OCT). Outcome measures after steroids were discontinued included development of recurrent fluid, time to recurrence, number of recurrences, type and timing of intervention, final BCVA and OCT findings.
Eleven (11) eyes from 7 patients were included in the study. Five (5) patients were on oral steroids, 1 on an inhaled steroid and 1 on a topical preparation. Initial VA ranged from 20/20 to counting fingers (CF). Eight eyes (72%) showed no improvement at 3 months after steroids were discontinued, necessitating treatment.<br /> <br /> This included intravitreal anti-VEGF injections in 7 eyes (64%) and/or focal laser photocoagulation (3 eyes [27%]). Without steroids, 8 eyes developed a recurrence of fluid, at times ranging from 2 to 7 months. The number of recurrences ranged from 1 to 3, with 1 eye never completely resolving. Patients were followed for an average of 32.8 months (range 15-59). All but 2 eyes achieved a BCVA of ≥ 20/50 (range 20/20 to CF). 72% (8) of the eyes had flat OCTs on most recent exam.
CSCR secondary to steroids is generally assumed to resolve and not recur once steroids are tapered and discontinued. Our patient population was found to have a high rate of recurrence of fluid, in addition to a tendency toward multiple recurrences, even after steroids had been discontinued. Although a larger study is needed, these patients need to be monitored closely.
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