Diagnosis and Treatment of Central Serous Chorioretinopathy in Patients with Scleritis

Author:

Tsai Yu-Chien12,Chen Yann-Guang2,Lee Yueh-Chang3,Hwang Yih-Shiou4567ORCID,Hsieh Yun-Hsiu2

Affiliation:

1. Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan

2. Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan

3. Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan

4. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan

5. College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

6. Department of Ophthalmology, Chang Gung Memorial Hospital, Xiamen 361000, China

7. Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 41265, Taiwan

Abstract

Central serous chorioretinopathy (CSCR) is characterized by central neurosensory retinal detachment from the retinal pigment epithelium. While the association between CSCR and steroid use is widely recognized, it is difficult to distinguish whether the subretinal fluid (SRF) in ocular inflammatory disease results from steroid use or an inflammation-related uveal effusion. We report the case of a 40-year-old man who presented to our department with intermittent redness and dull pain in both eyes that had persisted for three months. He was diagnosed with scleritis with SRF in both eyes and steroid therapy was started. Inflammation improved with steroid use, but SRF increased. This indicated that the fluid was not caused by the posterior scleritis-related uveal effusion but by steroid use. SRF and clinical symptoms subsided after steroids were discontinued completely and immunomodulatory therapy was initiated. Our study highlights that steroid-associated CSCR must be considered in the differential diagnosis of patients with scleritis, and prompt diagnosis with an immediate shift from steroids to immunomodulatory therapy can resolve SRF and clinical symptoms.

Publisher

MDPI AG

Subject

General Medicine

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