This study aimed to elucidate the potential relationship between central serous chorioretinopathy (CSC) and both endogenous hypercortisolism and the administration of exogenous corticosteroids. Case 1 involved a 39-year-old female patient who presented with blurred vision and metamorphopsia. Ophthalmologic examinations confirmed bilateral CSC. Biochemical and clinical evidence suggested hypercortisolism, and abdominal computed tomography revealed an adrenal adenoma, leading to a diagnosis of adrenocorticotropin-independent Cushing syndrome (CS). Postoperatively, a regression of serous retinal detachments was observed within 6 weeks. Case 2 referred to a 60-year-old male patient with hyperthyroidism and Graves orbitopathy who experienced vision loss after intravenous administration of 4.5 g of methylprednisolone over 10 weeks. Vision deteriorated after glucocorticoid therapy but improved 6 months later on discontinuation. Subsequently, the patient received peribulbar injections of triamcinolone acetonide, resulting in acute vision loss, with ophthalmologic examinations confirming CSC. After the cessation of exogenous corticosteroids, CSC resolved, and retinal pigment epithelium detachment also resolved at 3 months. Although causality cannot be definitively established with only 2 cases, the spontaneous resolution of subretinal fluid following corticosteroid withdrawal is highly indicative. The use of both endogenous hypercortisolism and exogenous corticosteroids is implicated as a risk factor for CSC, warranting increased vigilance from endocrinologists.
Pang et al. (Tue,) studied this question.