Warn patients to report visual disturbances during steroid treatment, GPs advised

Central serous chorioretinopathy (CSCR) is a retinal disorder that has been linked to the systemic use of corticosteroids. Recently, it has also been reported after local corticosteroid administration.

CSCR typically affects one eye only and can cause vision to be blurry and distorted. | Paul Whitten/SCIENCE PHOTO LIBRARY
CSCR typically affects one eye only and can cause vision to be blurry and distorted. | Paul Whitten/SCIENCE PHOTO LIBRARY

Patients taking local or systemic corticosteroids should be warned to report any blurred vision or other visual disturbances in view of the rare risk of CSCR, the MHRA has advised.

Blurred vision is an established side-effect of steroid treatment, and may be a symptom of cataract and glaucoma. In rare cases, however, it could indicate the presence of CSCR.

If a patient who has received corticosteroid treatment presents with visual symptoms, clinicians should consider referral to an ophthalmologist for evaluation of possible causes.

Retinal detachment

CSCR is characterised by the accumulation of subretinal fluid at the posterior pole of the fundus, ultimately causing retinal detachment. CSCR typically affects one eye only and can cause vision to be blurry and distorted, with objects often appearing smaller and distorted in the affected eye. Patients may also have difficulty with bright lights and contrast sensitivity.

Although the exact mechanism leading to the development of CSCR is unknown, several possible risk factors have been described, including use of systemic corticosteroids, pregnancy, and Cushing's syndrome. These risks are thought to be associated with the effect of cortisol on the eye.

CSCR has recently also been described after local administration of corticosteroids via inhaled and intranasal, epidural, intra-articular, topical dermal, and periocular routes.

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