Clinical profile of uveitis patients developing central serous chorioretinopathy: An experience at a tertiary eye care center in India

Abstract

Purpose: To evaluate clinical profile of patients with uveitis who developed central serous chorioretinopathy (CSC). Methods: Retrospective case series of consecutive patients of uveitis with CSC managed at a tertiary eye care center in India between 1994 and 2014. The data about clinical features, investigations, treatment, and outcomes were obtained from their medical records. Results: A total of 31 eyes of 26 patients with uveitis with a diagnosis of CSC between June 1994 and May 2014 were included in the study. The mean age of presentation was 42.8 ± 9.2 years, and 88.4% of the patients were male. CSC was bilateral in 19.2% of the patients, and in 38.4% patients uveitis was because of infectious etiology. CSC developed in 23 (88.5%) patients when they were on oral corticosteroid. The most common cause of uveitis in our study was choroiditis (48.4%), followed by retinal vasculitis (12.9%). The mean time for resolution of CSC was relatively less in patients with uveitis because of infectious etiology. In 10% eyes vision remained the same and deterioration of vision was noted in 19% eyes. Best corrected visual acuity of the patients at the time of presentation with CSC was 0.56 ± 0.34 and after the resolution of CSC was 0.48 ± 0.5 ( P < 0.0005). Conclusion: Patients with choroidal inflammations are more prone to develop CSC compared with other subtypes of uveitis. Management of CSC in uveitis can be challenging.

Outcomes of Retinal Pigment Epithelial Detachment in Vogt-Koyanagi-Harada Disease

“…CSC induced by corticosteroids has been reported to occur in a wide variety of ocular in ammatory conditions but with a relatively low incidence. Majumder et al revealed that the prevalence of CSC in uveitis was approximately 0.12% in a large retrospective study involving 22,721 patients in India [25]. We found that the speci c incidence rate of CSC in VKH was 1.06% in our cohort of 235 patients.…”

“…Increased permeability of the choriocapillaris under in ammatory conditions is a typical pathological change in VKH [1]. When choroidal in ammation causes increased vascular permeability, as well as long-standing in ammation breaks down the blood ocular barrier, accumulation of uid with abundant protein between RPE and Bruch membrane or under the neurosensory retina subsequently occurs, these are believed to be the theoretical bases of PED and ERD in VKH [25,27,7]. Brie y, the major cause of leakage in CSC is high hydrostatic pressure, while in VKH it is the in ammation.…”

“…If the therapy of rapid and aggressive high-dose systemic corticosteroid along with immunomodulatory and/or biologicals is adopted, close follow-up will be necessary to monitor the changes in PED and the occurrence of classic CSC, and timely adjustment of the therapeutic regimen may lower the risk of vision impairment. Discontinuation of corticosteroids is suggested as the rst step in the treatment of CSC in ocular in ammatory conditions, and adding immunosuppressants and/or biological agents may be required to control in ammation [25,31]. CSC leakage points outside the fovea could be treated with continuous-wave laser photocoagulation [25].…”

Central serous chorioretinopathy in uveitis patients after corticosteroid therapy: a report of 6 cases

“…In three of our six cases, inflammation involved the choroid. Predilection of CSCR for choroiditis entities has been reported previously [25].…”

“…Use of systemic and local corticosteroids can be involved in CSCR development. However, reports on CSCR in posterior uveitis patients receiving corticosteroid therapy are limited [22][23][24]25]. In our collective of 1793 cases of uveitis patients seen in our centre, 6 uveitis cases (0.3 %) treated with systemic corticosteroids developed CSCR.…”