Abstract
We investigated the rates of the use of steroids in Japanese central serous chorioretinopathy (CSC) cases and differences in the characteristics of CSC with and without steroids. A total of 538 eyes of 477 patients diagnosed with CSC, with 3 months or more of follow-up between April 2013 and June 2017 at 8 institutions. Patients with CSC with more than 3 months of follow-up were identified by OCT and fluorescein angiography at 8 institutions. Data collected included patient demographics, history of corticosteroid medication and smoking, spherical errors, findings of angiography, subfoveal choroidal thickness, and changes through the follow-up period. Differences in these findings were analyzed in cases with and without corticosteroid treatment. Among the 477 patients (344 men,133 women), 74 (15.5%) (39 men, 35 women) underwent current or prior steroid treatment. Cases with steroids were higher age (p = 0.0403) and showed no male prevalence, more bilateral involvement (p < 0.0001), and the affected eyes had multiple pigment epithelial detachment (p <0.0001), more fluorescein leakage sites (p < 0.0001), greater choroidal thickness (p = 0.0287) and a higher recurrence rate (p = 0.0412). Steroids can cause severer CSC through an effect on choroidal vessels and an impairment of retinal pigment epithelium.
Highlights
Central serous chorioretinopathy (CSC) is a disease in which serous retinal detachment is seen, often associated with detachment of the retinal pigment epithelium (RPE) [1,2,3,4,5,6,7,8,9,10]
Following data were obtained from affected eyes and if both eyes had CSC, we chose one eye with later onset or randomly; best corrected visual acuity, spherical equivalents, the numbers of regions showing leakage on Fluorescein angiography (FA), the presence of choroidal vascular hyperpermeability on laterphase indocyanine green angiography (ICGA), and subfoveal choroidal thickness were collected as possible
We examined the records of 538 eyes from 477 patients (344 men and 133 women, M/F ratio 2.6:1) by CSC in 8 hospitals
Summary
Central serous chorioretinopathy (CSC) is a disease in which serous retinal detachment is seen, often associated with detachment of the retinal pigment epithelium (RPE) [1,2,3,4,5,6,7,8,9,10]. Increases in the permeability of the choroidal vessels result in pigment epithelial detachment (PED) and exudation of fluid into the subretinal space. An association with corticosteroids had been postulated, and since Wakakura and Ishikawa [11] demonstrated 5 cases showing worsening of CSC during corticosteroid therapy in the Japanese-language literature in 1980, more attention has been paid to the risk of steroids with respect to CSC. A history of CSC can increase the risk of neovascular age-related macular degeneration (AMD), especially polypoidal choroidal vasculopathy, and recent studies indicate a common feature of thick choroid among these diseases [23,24,25].
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