Atypical Central Serous Chorioretinopathy

Abstract

Bullous central serous chorioretinopathy (CSCR) is a rare variant of CSCR characterized by severe serous retinal detachment which especially involves the inferior quadrants. Corticosteroid therapy administered for systemic or ocular misdiagnoses may induce and exacerbate CSCR. The purpose of this study was to report diagnosis and treatment results of an unusual case of bullous CSCR induced by systemic and periocular corticosteroid therapy received at another medical center due to a misdiagnosis of Vogt-Koyanagi-Harada disease.

Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

“…Elimination of risk factors is advisable in bCSCR as in CSCR. In particular, systemic corticosteroid withdrawal is suggested as the first step, if possible, according to systemic conditions (e.g., previous organ transplant) [ 9 , 18 , 25 , 28 , 30 , 31 , 32 ]. Kunavisarut et al stopped steroid medication in six patients and tapered it in one (adding azathioprine).…”

“…Cebeci et al combined PDT and laser photocoagulation with 25 mg oral eplerenone twice daily [ 31 ]. In particular, a patient affected by bilateral bCSCR was treated with reduced-fluence PDT (25 J/cm 2 , 3000 mW/cm 2 ) in the right eye (RE) seen at ICGA and with laser photocoagulation left eye (LE).…”

“…The ERD was reduced at one month in the RE and resolved in the LE at one month of follow-up. BCVA improved from light perception to counting finger in RE and from 20/32 to 20/25 in the LE [ 31 ]. Finally, further studies are warranted to define the efficacy and duration of this treatment.…”

“…Eight articles were excluded: six not written in English, 1 review papers and 1 ex vivo studies. After full-text evaluation, 34 studies about bCSCR were included [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 17 , 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Photodynamic therapy for bullous retinal detachment: a single-center experience of case series with a 6-month follow-up study

“…A previous study reported that glucocorticoids can reduce macular edema and aggravate SRF accumulation in CSC patients [ 6 ]. Additionally, in previous reports, the occurrence of bullous retinal detachment was also associated with a history of glucocorticoids [ 7 , 8 ].…”