title: Changes in choroidal thickness after systemic administration of high-dose corticosteroids: a pilot study.
abstract: OBJECTIVE
  To characterize the effects of corticosteroids on choroidal thickness, we measured the choroid thickness in patients treated systemically with a high-dose corticosteroid.
  
  
  METHODS
  A prospective, pilot study was conducted on 20 patients who required high-dose corticosteroid pulse therapy (>500 mg/d). Choroidal thickness was measured at baseline, 1 day, 1 week, and 1 month after corticosteroid administration. Blood pressure was measured four times a day for the first 5 days of steroid treatment.
  
  
  RESULTS
  This study ultimately included 35 eyes from 18 patients. Each patient was treated with high-dose corticosteroid therapy at a concentration of 19.5 ± 4.1 mg per kg body weight for 5.2 ± 1.1 days. Mean subfoveal choroidal thickness at baseline was 259.8 μm (range, 86.4-394.7 μm). Choroidal thickness showed no significant change at 1 day, 1 week, or 1 month after corticosteroid administration (P = 0.197). Mean systolic blood pressure increased by 13 mmHg (P = 0.008), but diastolic pressure did not change (P = 0.117). One patient (5.6%) who had presented with pigment epithelial detatchment (PED) and thick choroid (381.1 μm) developed bilateral focal subretinal fluid during the study and showed central serous chorioretinopathy (CSC) with a 13.1% increase in subfoveal choroidal thickness.
  
  
  CONCLUSIONS
  No consistent changes in choroidal thickness were observed after systemic high-dose corticosteroid treatment, but one patient with PED and thick choroid showed an increase in choroidal thickening as well as features of CSC. Thus, steroid-induced CSC may be an idiosyncratic response in selected vulnerable individuals rather than a dose-dependent effect.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Jeong Mo
authors.initials: JM
authors.lastname: Han
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Hwang
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Park
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D002829:Choroid / Q000187:drug effects / Q000473:pathology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: central serous chorioretinopathy; choroid; glucocorticoid; optical coherence tomography; prednisolone