title: Central serous chorioretinopathy resulting in altered vision and color perception after glenohumeral corticosteroid injection.
abstract: Complications from shoulder corticosteroid injections are uncommon. This article presents a case of altered color perception and visual disturbances in a 29-year-old male active duty Navy SEAL following an intra-articular glenohumeral corticosteroid injection, previously unreported in the orthopedic literature. The corticosteroid injection was administered for the treatment of right-shoulder stiffness occurring approximately 3 months following an arthroscopic superior labrum anterior-posterior (SLAP) repair and subacromial decompression of the ipsilateral shoulder. The patient experienced immediate relief after the injection. Seven days later, however, he began to notice visual disturbances with color and image distortion of his right eye. He also developed a papular, nonpruritic rash on his upper trunk that eventually extended down his legs. He was diagnosed by an ophthalmologist as having central serous chorioretinopathy, a condition in which serous fluid accumulates in the subretinal space of the eye, causing detachment of the retina from the underlying retinal pigment epithelium. The reaction spontaneously resolved within approximately 10 to 12 weeks without treatment. Although intra-articular corticosteroid injections are frequently performed with a low rate of complication, clinicians should be familiar with this rare yet distressing condition. Furthermore, patients with increased production of endogenous corticosteroids (eg, those with Cushing's syndrome, type A personality, hypertension, or obstructive sleep apnea) should be warned of the potential of chorioretinopathy after an intra-articular corticosteroid injection.
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hurvitz
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Hodapp
authors.forename: Jason
authors.initials: J
authors.lastname: Jadgchew
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Solomon
authors.forename: Hunter S
authors.initials: HS
authors.lastname: Stolldorf
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Provencher
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000328:Adult; D002825:Chorioretinitis / Q000139:chemically induced* / Q000175:diagnosis; D003117:Color Vision Defects / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007270:Injections, Intra-Articular / Q000009:adverse effects; D008297:Male; D019534:Shoulder Impingement Syndrome / Q000188:drug therapy; D012785:Shoulder Joint; D015354:Vision, Low / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000305:Adrenal Cortex Hormones