Role of corticosteroids in CSCR

Abstract

AbstractPurpose Central serous chorioretinopathy (CSCR) is a relatively common retinal disease characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal and/or pigment epithelium detachment.Methods Numerous reports during the past few years have provided us with arguments strengthening the hypothesis of a possible association between CSCR and glucocorticoids.Results It has been noted that central serous chorioretinopathy is associated with different conditions, characterized by exposure to increased levels of endogenous or exogenous glucocorticoids. In fact, central serous chorioretinopathy has been described in patients with endogenous Cushing’s syndrome. It is also prevalent in patients with type‐A personality; it has been reported following stressful events, whereas pregnancy represents another possible risk factor. These conditions are all characterized by endogenous hypercortisolism. In addition, many cases of central serous chorioretinopathy have been described during or following treatment with glucocorticoids, administrated by any route, for various systemic or ocular conditions. Central serous chorioretinopathy, when related to exposure to exogenous glucocorticoids, has a less prominent male predilection, presents more often with a chronic or atypical form, and is frequently bilateral. Furthermore, treatment of CSCR with glucocorticoids was found to exacerbate the clinical picture. However,very few patients worldwide are suffering from CSCR, while under systemic steroid treatment.Conclusion It could be suggested that glucocorticoids may be involved in the development of central serous chorioretinopathy. Glucocorticoids should not be used in the treatment of central serous chorioretinopathy.