Associations Between Topical Ophthalmic Corticosteroids and Central Serous Chorioretinopathy: A Taiwanese Population-Based Study

Abstract

Results strongly support an association between recent topical ophthalmic corticosteroid use and CSCR. Thus, patients who require ophthalmic corticosteroids should be advised of the associated risk of developing CSCR.

Patient characteristics and risk factors for central serous chorioretinopathy: an analysis of 811 patients

“…The role of corticosteroids in CSC pathophysiology is not clearly understood. They cause microthrombus formation and increased blood viscosity by inducing platelet aggregation and vasoconstriction 13. Long-term use of corticosteroids increases choroidal hyperpermeability and the fragility of the choriocapillaris 13.…”

“…They cause microthrombus formation and increased blood viscosity by inducing platelet aggregation and vasoconstriction 13. Long-term use of corticosteroids increases choroidal hyperpermeability and the fragility of the choriocapillaris 13. In a study conducted in 1999, Tittl et al reported that patients with chronic CSC were more likely to use steroids than patients with classic CSC 8.…”

Central serous chorioretinopathy in the fellow eye as a complication of intravitreal dexamethasone implant for the treatment of Irvine‐Gass syndrome

“…These may lead to microthrombus formation and increased blood viscosity, which might alter choroidal perfusion and vascular permeability. In addition, corticosteroids may result in choriocapillary ion‐pumping dysfunction by inhibiting collagen formation and altering ion and water transport in epithelia …”

“…Another mechanism that has been proposed recently concerns corticosteroid‐induced choriocapillary hypermeability via mineralocorticoid receptor activation. Corticosteroids bind with high affinity not only to the glucorticosteroid receptor but also to the mineralocorticoid receptor, resulting in choroid hypermeability …”

“…8,19 Available data from another populationbased study on the association between topical ophthalmic corticosteroids and central serous chorioretinopathy indicate that patients who had used topical ophthalmic corticosteroids within a year before the index date of diagnosis of central serous chorioretinopathy in the treated eye were at higher risk of developing central serous chorioretinopathy than controls. 20 No data are available regarding development of central serous chorioretinopathy in the fellow eye after topical ophthalmic administration of steroids. Dosage of corticosteroids seems to be of great importance as higher dosages lead to a shorter latency of central serous chorioretinopathy in a dose-dependent manner.…”