Retinal pigment epithelial changes associated with systemic corticosteroid treatment

Background: It is well known that topical as well as systemic treatment with corticosteroids may have ocular side effects. The most common are the development of cataract and increase of intraocular pressure, however, alteration of the retinal pigment epithelium may also occur. Patient: A 64-year old male experienced a progressive decrease of visual acuity over a time period of 6 weeks. Ophthalmologic examination revealed a severe diffuse retinal pigment epitheliopathy with serous detachment of the neurosensory retina. This patient was treated with systemic methylprednisolone for chronic glomerulonephritis. After cessation of the treatment with systemic corticosteroids visual acuity improved and the serous retinal detachment resolved. Conclusion: Ophthalmologic examination including biomicroscopy of the retina is recommended on a regular basis for patients treated with systemic corticosteroids. With development of pigment epithelial changes steroids should be reduced or discontinued if possible.