Delayed Onset of Central Serous Chorioretinopathy following Corticosteroid Treatment for Giant Cell Arteritis: A Case Report.

Abstract

Introduction: Central serous chorioretinopathy (CSCR) is a known complication of corticosteroid use, characterized by the accumulation of subretinal fluid (SRF), which can lead to changes in vision. Giant cell arteritis (GCA) is a systemic vasculitis that often necessitates high-dose corticosteroid treatment to prevent serious complications including permanent vision loss. Although the association between CSCR and corticosteroids is well established, its occurrence in patients diagnosed with GCA remains rarely reported in literature.

Case presentation: We present a case of a 71-year-old man who developed CSCR following 6 months of corticosteroid treatment for GCA. The patient presented with decreased vision in the left eye for 10 days, prompting ophthalmologic evaluation. Initial visual acuity (VA) was measured at 20/60, and OCT identified the presence of SRF, confirming CSCR as the underlying etiology. Following gradual tapering of his prednisone dosage, subsequent OCT confirmed significant reduction in SRF, with VA improving to 20/30 within 3 months.

Conclusion: This case highlights the importance of considering CSCR in the differential diagnosis of new or worsening visual symptoms in GCA patients receiving corticosteroids. The risk for corticosteroid-induced CSCR in these patients creates a diagnostic challenge, as worsening vision may be incorrectly attributed to disease progression rather than being recognized as a treatment-related adverse effect. This case emphasizes the importance of early recognition of CSCR and highlights the need for interdisciplinary collaboration between rheumatologists and ophthalmologists to ensure appropriate management for patients with GCA.