Central Serous Chorioretinopathy After Renal Transplantation

In Brief Purpose: To describe the demographic and clinical characteristics of central serous chorioretinopathy (CSC) after renal transplantation (RT). Methods: A retrospective medical chart review was performed on 451 among 2,980 patients, who underwent RT and visited vitreoretinal clinic at Yonsei Medical Center from 1979 to 2009. Correlation between daily corticosteroid dosage and remission time and factors relating to final visual acuity of <20/40 were studied. Results: Twenty-eight patients (39 eyes) developed CSC at a median of 63 months after RT (range, 2 months to 20 years), and 18 (64%) patients were men. Accordingly, the prevalence of CSC after RT was estimated to be between 1% and 6%. All patients received a combination of corticosteroid and at least one other immunosuppressant agent at presentation. Reducing the daily corticosteroid dosage by 25% to 50% in CSC with classic pattern resulted in twice as faster remission (2 months) compared with the maintained dosage group (P = 0.025). Central serous chorioretinopathy recurrence (P = 0.002), intrinsic renal disease as cause of RT (P = 0.003), severe CSC variant (P = 0.009), and presenting visual acuity <20/40 (P = 0.009) predicted a final visual acuity <20/40. Conclusion: Central serous chorioretinopathy develops relatively often after RT and varies in presentation and severity. The cause of CSC after RT appears to be multifactorial and closely related to corticosteroid. Central serous chorioretinopathy developed in 1% to 6% of renal transplant recipients and reducing corticosteroid accelerated remission. Recurrence, intrinsic renal disease, severe central serous chorioretinopathy variants, and poor visual acuity predicted final visual acuity of <20/40.