Bilateral Bullous Exudative Retinal Detachment Complicating Idiopathic Central Serous Chorioretinopathy during Systemic Corticosteroid Therapy

Park

et al. 2015

Eye

Purpose Pregnancy is a known predisposing factor for central serous chorioretinopathy (CSC). Choroidal thickness (CT) increases in patients with CSC. This study was designed to evaluate CT in pregnant women. Patients and methods This was a prospective study. Fourteen healthy pregnant women and seven patients with pre-eclampsia were included. Twenty-one normal subjects were also recruited. CT was measured using enhanced-depth imaging optical coherence tomography.Results The mean CT of normal subjects, healthy pregnant women and patients with pre-eclampsia were 264.95 ± 21.03, 274.23 ± 29.30 and 389.79 ± 25.13 μm, respectively (normal subjects vs healthy gravidas: P40.05; normal subjects vs pre-eclampsia: Po0.001; healthy gravidas vs pre-eclampsia: Po0.001). CT decreased from 381.05 ± 22.96 μm to 335.17 ± 9.97 μm 1 week after delivery in patients with pre-eclampsia. Conclusions Pregnancy itself did not increase CT, whereas pre-eclampsia did appear to result in increased CT. This suggests that additional unknown factors induce hyperpermeability in pregnant women.

Section: Discussioncontrasting

confidence: 73%

Comparison of subfoveal choroidal thickness in healthy pregnancy and pre-eclampsia

Park

et al. 2015

Eye

“…The clinical characteristics of CSC, which include male predominance, relation to corticosteroid medication, or gestation, have been previously thought to indicate that this condition might not be confined to the retina or choroid. [16][17][18][19][20][21] Choroidal vascular features on ICGA and choroidal thickening on OCT in the unaffected fellow eyes suggest that there may be some subclinical 'latent' phase of CSC that may precede the clinical manifestation of CSC. Also, this subclinical process may cause retinal pigment epithelial alterations and detachment or subretinal fluid accumulation by causing an increase in hydrostatic pressure.…”

Section: Discussionmentioning

confidence: 99%

Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy

Kang

Bai

2011

Eye

124

101

Objective To assess the change in the choroidal thickness of the unaffected eyes in patients with unilateral central serous chorioretinopathy (CSC). Methods Thirty eyes with unilateral idiopathic CSC and 30 age-matched normal eyes were included in this study. Choroidal thickness was evaluated from images obtained by enhanced depth image optical coherence tomography. The choroidal thicknesses of the affected eyes, unaffected eyes, and normal eyes were analyzed. Choroidal vascular dilation and hyperpermeability on indocyanine green angiography (ICGA) were analyzed and correlated with the changes in choroidal thickness. Results The mean choroidal thicknesses of the affected eyes, unaffected fellow eyes, and normal individuals were 445.58 ± 100.25, 378.35±117.44, and 266.80±55.45 lm, respectively. Compared with normal eyes, subfoveal choroidal thickness was increased significantly in the eyes with active CSC and in the unaffected fellow eyes (Po0.001 in both groups). The choroidal thickness was significantly greater in the eyes with active CSC than in the unaffected fellow eyes (P ¼ 0.003). ICGA revealed choroidal vascular hyperpermeability in 28 (93.3%) eyes with CSC and in 23 (73.3%) unaffected fellow eyes. Choroidal vascular dilation was detected in 21 (70.0%) eyes with CSC and in 18 (60.0%) unaffected fellow eyes. Conclusion Increased choroidal thickness in patients with unilateral CSC was noted not only in the affected eyes, but also in the unaffected fellow eyes. The results of this study suggest that CSC might be an essentially bilateral disorder.

“…This has been reported by Wessing et al as an increase in the subretinal fluid in patients under systemic steroid treatment [8]. Gass et al has also shown that glucocorticoids used for the treatment of CSC may intensify the condition [6].…”

Section: Discussionmentioning

confidence: 78%

“…This atypical presentation following systemic corticosteroid therapy may be complicate diagnosis of ICSC [5,6].…”

mentioning

confidence: 99%

Atypical Central Serous Chorioretinopathy with Bilateral Bullous Exudative Retinal Detachment Following Systemic Corticosteroid Therapy

Entezari¹

2017

IJOAO

Purpose: To report a case of an atypical idiopathic central serous chorioretinopathy (ICSC) with bilateral retinal detachment following intravenous high-dose corticosteroid therapy. Methods:A 24 year-old girl presented with sudden painless visual loss in both eyes. Complete ophthalmic examination, fluorescein angiography (FA), indocyanin green angiography (ICG), and optical coherence tomography (OCT) were done and patient was followed for six months.Results: Loss of vision in her right eye and progression of visual loss in left eye were developed after intra-venous steroid therapy. Best corrected visual acuity (BCVA) was 1/10 and 2/10 in her right and left eyes, respectively. In funduscopic examination, we found bullous exudative retinal detachment in her both eyes without vitreous reaction. Fundus fluorescein angiography (FA) revealed diffuse leakage and indocyanin green angiography (ICG) showed evidence of diffuse choroidopathy. Optical coherence tomography revealed multiple neurosensory and pigment retinal detachments. The patient was followed with impression of atypical bilateral ICSC without any treatment. Visual acuity improved and retinal attachment occurred in both eyes during 6 months.Conclusions: Diagnosis of atypical ICSC and role of corticosteroids on development of ICSC must be considered in this special cases with bilateral bullous retinal detachment.