Central serous chorioretinopathy: A complication of glucocorticoid excess

Central serous chorioretinopathy (CSCR) is a disorder characterized by the accumulation of subretinal fluid at the posterior pole of the fundus resulting in diminished visual acuity and distortions of visual perception. Although most reported cases are idiopathic, CSCR is also a recognized rare complication of the hypercortisolemia of pituitary-adrenal disease or, more commonly, of exposure to synthetic corticosteroids or adrenocorticotrophic hormone. When CSCR is related to steroid exposure, significant improvement is anticipated if steroid levels are restored to normal. Irreversible visual damage can occur if corticosteroid therapy is continued. We describe the cases of steroid-related instances of CSCR that have been reported in the English-language, peer-reviewed journals since 1966 (when the connection was first noted) and 2 additional patients we have encountered, 1 with asthma, the other with endocrine orbitopathy.