Published: 6 September 2018

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Corticosteroids and Central Serous Chorioretinopathy (CSCR)

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Prescriber Update 39(3): 39
September 2018

Key Messages

  • Central serous chorioretinopathy is a retinal disorder associated with use of topical and systemic corticosteroids.
  • Refer patients who present with blurred vision or other visual disturbances while taking corticosteroids to an ophthalmologist or optometrist for evaluation of the underlying causes.


Central serous chorioretinopathy (CSCR) has been reported with both topical (inhaled, intranasal, epidural, intra-articular, dermal and periocular routes) and systemic corticosteroid use1.

Up to 30 June 2018, the Centre for Adverse Reactions Monitoring (CARM) had received one case report of CSCR and two case reports of retinal detachment associated with corticosteroid use (CARM ID numbers: 128846, 023340, 120887).

CSCR occurs when fluid accumulates beneath the retina. This causes detachment of the retina from the underlying pigment epithelium and choroid2. Usually, just one eye is affected3.

Symptoms of CSCR include blurred or distorted vision, blind spots, micropsia, sensitivity to bright light and reduced contrast sensitivity3,4.

In addition to CSCR, other causes of blurred vision or visual disturbances may include cataracts or glaucoma, which are recognised adverse reactions for both systemic and topical corticosteroids5–7.

Temporary blurred vision may occur when a topical corticosteroid eye product is administered8. This will not usually require medical attention.

Medsafe is working with sponsors to include safety information about CSCR in the New Zealand data sheets for all corticosteroid-containing products.

Refer patients who present with symptoms such as blurred vision or other visual disturbances while taking corticosteroids to an ophthalmologist or optometrist for evaluation of possible causes.

Please report any adverse reactions to corticosteroids to CARM (https://nzphvc.otago.ac.nz/report/).

References
  1. Medicines and Healthcare products Regulatory Agency. 2017. Corticosteroids: rare risk of central serous chorioretinopathy with local as well as systemic administration. Drug Safety Update 11(1): 2. URL: www.gov.uk/drug-safety-update/corticosteroids-rare-risk-of-central-serous-chorioretinopathy-with-local-as-well-as-systemic-administration (accessed 4 July 2018).
  2. Arroyo G. 2018. Retinal detachment. In: UpToDate 10 January 2018. URL: www.uptodate.com/contents/retinal-detachment (accessed 4 July 2018).
  3. Royal National Institute of Blind People. 2018. Central serous retinopathy. URL: www.rnib.org.uk/eye-health/eye-conditions/central-serous-retinopathy (accessed 4 July 2018).
  4. Liew G, Quin G, Gillies M, et.al. 2013. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clinical & Experimental Ophthalmology 41: 201–14. URL: www.ncbi.nlm.nih.gov/pubmed/22788735 (accessed 4 July 2018).
  5. Apotex NZ Ltd. 2018. APO-Prednisone Tablets New Zealand Data Sheet. 11 June 2018. URL: www.medsafe.govt.nz/profs/datasheet/a/Apoprednisonetab.pdf (accessed 4 July 2018).
  6. GlaxoSmithKline NZ Limited. 2015. Flixotide Inhaler New Zealand Data Sheet. 5 October 2015. URL: www.medsafe.govt.nz/profs/Datasheet/f/FlixotideCFCfree.pdf (accessed 4 July 2018)
  7. Mylan New Zealand Limited. 2015. Alanase Aqueous Nasal Spray New Zealand Data Sheet. 16 June 2015. URL: www.medsafe.govt.nz/profs/datasheet/a/Alanasenasalspr.pdf (accessed 4 July 2018).
  8. Novartis New Zealand Limited. 2018. Maxidex Ophthalmic Suspension and Ointment New Zealand Data Sheet. 26 March 2018. URL: www.medsafe.govt.nz/profs/Datasheet/m/Maxidexeyedropsoint.pdf (accessed 4 July 2018).
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