Abstract
BackgroundTo evaluate the retinal and choroidal alterations in steroid-associated central serous chorioretinopathy (CSC) in comparison to idiopathic CSC.MethodsIn this retrospective cohort study, swept source optical coherence tomography scans of eyes with steroid-associated CSC (group A) were compared with the same in idiopathic CSC (group B). The key features included central subfield retinal thickness, subfoveal choroidal thickness, subfoveal large choroidal vessel diameter, subretinal deposits, retinal pigment epithelial irregularities, double layer sign, hyperreflective dots, intraretinal fluid, and choroidal vascularity index (ratio of choroidal luminal area and total choroidal area, measured on a high definition horizontal 9 mm OCT B-scan.ResultsThere were 20 eyes in group A and 30 in group B. Group A had a higher female proportion (60 vs. 16.67%; P < 0.01) and higher bilaterality (30 vs. 6.67%; P = 0.03). The height of neurosensory detachment was lower in group A (153.1 ± 175.70 µm vs. 312.9 ± 223.06 µm; P < 0.01). There was no significant difference in the prevalence of subretinal deposits, retinal pigment epithelial irregularities, pigment epithelial detachments, double layer sign, outer retinal layer disruption, and intraretinal fluid. Hyperreflective dots (HRDs) were less common in group A (15 vs. 46.67%; P = 0.03). The subfoveal choroidal thickness (P = 0.65) and subfoveal large choroidal vessel diameter (P = 0.78) were comparable. There was a trend towards a higher choroidal vascularity index (CVI) in group A (A: mean, 82%, 95% CI, 66–99%; B: mean, 58%, 95% CI, 57–59%; P = 0.10).ConclusionSteroid-associated CSC has a marginally higher CVI and less common association with HRDs as compared to idiopathic CSC.
Highlights
To evaluate the retinal and choroidal alterations in steroid-associated central serous chorioretinopathy (CSC) in comparison to idiopathic CSC
It has been postulated that steroids cause inhibition of collagen synthase, increased permeability of choroidal capillaries, and dysfunction of ionic pump in the retinal pigment epithelium [21, 22] leading to the accumulation of subretinal fluid
By using enhanced depth imaging- optical coherence tomography (EDI-OCT), it has been observed that subfoveal choroidal thickness (SFCT) is increased in eyes with CSC as compared to normal eyes [29,30,31] In addition, we reported that in patients with acute CSC, “choroidal vascularity index” (CVI), a ratio of luminal area and total choroidal area, is significantly higher as compared to the fellow eyes and normal age-matched controls [32]
Summary
To evaluate the retinal and choroidal alterations in steroid-associated central serous chorioretinopathy (CSC) in comparison to idiopathic CSC. Corticosteroid-induced CSC is more likely to be bilateral and atypical than idiopathic CSC [10]. It has been postulated that steroids cause inhibition of collagen synthase, increased permeability of choroidal capillaries, and dysfunction of ionic pump in the retinal pigment epithelium [21, 22] leading to the accumulation of subretinal fluid. Corticosteroids are known to stimulate release of catecholamines and to potentiate their effects, which could potentially cause microcirculatory changes in the choroidal vasculature leading to CSC [23]. Glucocorticoids are known to increase platelet aggregation, thereby causing hypercoagulability, increased microthrombus formation, increased blood viscosity, all of which could affect the choroidal microcirculation [24, 25]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
