Can long-term corticosteriods lead to blindness? A case series of central serous chorioretinopathy induced by corticosteroids.
BACKGROUND
Long-term, high-dose corticosteroid therapy is well-known to cause systemic and ocular complications. A lesser known complication is chronic central serous chorioretinopathy (CSCR). Although idiopathic central serous chorioretinopathy (CSCR) is known to be mild with spontaneous recovery and minimal effects on the final visual acuity, chronic CSCR as a complication of long- term steroid therapy behaves differently, and may cause irreversible visual impairment.


METHODS
Three cases of chronic, recurrent CSCR were precipitated by longterm corticosteroids prescribed for post-renal transplant immunosuppressive therapy, postpituitary surgery and pemphigus vulgaris.


RESULTS
Two cases resolved with tapering of corticosteroids while one case was treated by focal laser photocoagulation. Two eyes had severe impairment of vision as a result of subretinal scar formation while the other 4 eyes had mild reduction of visual acuity from retinal epithelium pigment atrophy.


CONCLUSIONS
Long-term corticosteroid therapy can be complicated by severe, chronic and recurrent CSCR and occasionally peripheral exudative retinal detachment. This may result in subretinal fibrosis and permanent loss of vision.
Loo
Jing-Liang
JL
Singapore National Eye Centre, Singapore.
Lee
Shu-Yen
SY
Ang
Chong-Lye
CL
D000328:Adult; D001766:Blindness / Q000139:chemically induced*; D015862:Choroid Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects; D012163:Retinal Detachment / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
D005938:Glucocorticoids; D011239:Prednisolone; D006854:Hydrocortisone