Visual outcome after discontinuation of corticosteroids in atypical severe central serous chorioretinopathy

Purpose: To elucidate the effect of discontinuation of corticosteroids in patients with atypical severe central serous chorioretinopathy (CSC) on retinal reattachment, resolution of retinal pigment epithelium (RPE) leaks, and improvement in visual acuity (VA). Design: Prospective, noncomparative, observational case series. Participants: Twenty-four eyes of 17 patients who were being treated with corticosteroids for atypical severe CSC. Of these 17 patients, 16 were treated inappropriately with corticosteroids for their ocular condition; presumably, these patients' conditions were misdiagnosed, and they were thought to have choroiclitis, Harada's syndrome, or similar entities, and not central serous chorioretinopathy. Intervention: Observation or laser photocoagulation. Main Outcome Measures: Reattachment of the retina, obliteration of RPE leaks on funclus fluorescein angiography, and improvement in Snellen VA. Results: Discontinuation of corticosteroids resulted in reattachment of the retina in 21 eyes (87.5%), with median time to reattachment of 49 days (range, 32-400); only 3 eyes required laser photocoagulation. Fundus fluorescein angiography showed obliteration of RPE leaks at a median period of 75 days (range, 32-400) in the observed eyes; the median VA improved from 20/80 to 20/30. The mean follow-up was 16.5 months. Conclusions: Discontinuation of corticosteroids in atypical CSC helped in obliteration of RPE leaks and retinal reattachment in 87.5% of the eyes without laser treatment, and improvement in VA was observed. (C) 2004 by the American Academy of Ophthalmology.