Visual outcome after discontinuation of corticosteroids in atypical severe central serous chorioretinopathy.
OBJECTIVE
To elucidate the effect of discontinuation of corticosteroids in patients with atypical severe central serous chorioretinopathy (CSC) on retinal reattachment, resolution of retinal pigment epithelium (RPE) leaks, and improvement in visual acuity (VA).


METHODS
Prospective, noncomparative, observational case series.


METHODS
Twenty-four eyes of 17 patients who were being treated with corticosteroids for atypical severe CSC. Of these 17 patients, 16 were treated inappropriately with corticosteroids for their ocular condition; presumably, these patients' conditions were misdiagnosed, and they were thought to have choroiditis, Harada's syndrome, or similar entities, and not central serous chorioretinopathy.


METHODS
Observation or laser photocoagulation.


METHODS
Reattachment of the retina, obliteration of RPE leaks on fundus fluorescein angiography, and improvement in Snellen VA.


RESULTS
Discontinuation of corticosteroids resulted in reattachment of the retina in 21 eyes (87.5%), with median time to reattachment of 49 days (range, 32-400); only 3 eyes required laser photocoagulation. Fundus fluorescein angiography showed obliteration of RPE leaks at a median period of 75 days (range, 32-400) in the observed eyes; the median VA improved from 20/80 to 20/30. The mean follow-up was 16.5 months.


CONCLUSIONS
Discontinuation of corticosteroids in atypical CSC helped in obliteration of RPE leaks and retinal reattachment in 87.5% of the eyes without laser treatment, and improvement in VA was observed.
Sharma
Tarun
T
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, India. tarusharma@eth.net
Shah
Nitant
N
Rao
Madhav
M
Gopal
Lingam
L
Shanmugam
Mahesh P
MP
Gopalakrishnan
Mahesh
M
Bhende
Pramod
P
Bhende
Muna
M
Shetty
Nitin S
NS
Baluswamy
Sukumar
S
D000328:Adult; D002199:Capillary Permeability / Q000187:drug effects / Q000502:physiology; D015862:Choroid Diseases / Q000188:drug therapy / Q000503:physiopathology; D005122:Exudates and Transudates; D005260:Female; D005355:Fibrosis; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000503:physiopathology*; D011446:Prospective Studies; D012163:Retinal Detachment / Q000188:drug therapy / Q000503:physiopathology*; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology*
D005938:Glucocorticoids