Corticosteroids and central serous chorioretinopathy.
OBJECTIVE
The purpose of this study is to investigate the relationship between corticosteroid use and central serous chorioretinopathy (CSC).


METHODS
A prospective, case-controlled study.


METHODS
A consecutive series of patients with acute manifestations of CSC and a control group matched for age, race, and gender were recruited between January 2000 and July 2000.


METHODS
A detailed clinical history was taken, and fundus examination with slit-lamp biomicroscopy was performed on all patients. Fluorescein angiography was obtained on the study patients.


RESULTS
A total of 50 patients was recruited. Twenty-six patients (52%) had a history of exogenous steroid use, including oral, intravenous, intranasal, and intraarticular administration. Two additional patients had a history of endogenous hypercortisolism (Cushing's syndrome). In a matched control group, eight patients (18%) had a history of steroid use. The difference in corticosteroid exposure between study patients and controls was statistically significant (P < 0.0001).


METHODS
History of corticosteroid use or Cushing's syndrome.


CONCLUSIONS
This study is consistent with previous reports associating steroid use with CSC. It identifies corticosteroids as a significant risk factor for the development of acute, exudative macular manifestation and implicates hypercortisolism as a factor in the pathogenesis of this disorder. Several forms of corticosteroid administration were observed to be a risk factor for CSC. Accordingly, susceptible patients in need of corticosteroids should be advised of the risk of developing acute manifestations of CSC.
D000281:Administration, Intranasal; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015862:Choroid Diseases / Q000139:chemically induced* / Q000209:etiology; D003480:Cushing Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012164:Retinal Diseases / Q000139:chemically induced* / Q000209:etiology
D000305:Adrenal Cortex Hormones