Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids.
OBJECTIVE
The purpose of the study is to investigate the relationship between inhaled or intranasal adrenergic agonists and corticosteroids and the development of central serous chorioretinopathy (CSC).


METHODS
The medical records of three patients with CSC who were found to use inhaled adrenergic agents or corticosteroids or both were identified prospectively. A survey of members of the Retina, Macula, and Vitreous societies and the National Registry of Drug-Induced Ocular Side Effects identified three additional cases.


RESULTS
Six patients with CSC were found to be chronic users of corticosteroid (four patients) or both beta adrenergic agonist and corticosteroid (two patients) metered dose inhalers or nasal sprays. In three cases, there was a close temporal correlation between the use of a corticosteroid nasal spray and the development of CSC.


CONCLUSIONS
These findings suggest that, in patients who are susceptible, the periocular or systemic absorption of inhaled corticosteroids may be sufficient to produce CSC in humans, supporting previous hypotheses regarding the pathogenesis of the disorder. Further studies are needed to confirm this association and to determine whether inhaled adrenergic agents also contribute to the development of this disorder. Patients in whom CSC develops while using corticosteroid inhalers or nasal sprays should be alerted to the possible relationship between CSC and these agents.
Haimovici
R
R
Boston University School of Medicine, Massachusetts 02114, USA.
Gragoudas
E S
ES
Duker
J S
JS
Sjaarda
R N
RN
Eliott
D
D
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000009:adverse effects*; D000328:Adult; D000420:Albuterol / Q000009:adverse effects; D000730:Androstadienes / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy; D001507:Beclomethasone / Q000009:adverse effects; D001991:Bronchitis / Q000188:drug therapy; D015862:Choroid Diseases / Q000139:chemically induced* / Q000473:pathology; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D000068298:Fluticasone; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000473:pathology; D011446:Prospective Studies; D012163:Retinal Detachment / Q000139:chemically induced; D012164:Retinal Diseases / Q000139:chemically induced* / Q000473:pathology; D012220:Rhinitis / Q000188:drug therapy; D012307:Risk Factors; D014222:Triamcinolone Acetonide / Q000009:adverse effects; D014792:Visual Acuity
D000318:Adrenergic beta-Agonists; D000730:Androstadienes; D005938:Glucocorticoids; D000068298:Fluticasone; D014222:Triamcinolone Acetonide; D001507:Beclomethasone; D000420:Albuterol