Incidence, Management, and Outcomes of Eyes with Comorbid Active Uveitis and Central Serous Chorioretinopathy

Abstract

Purpose: To investigate the incidence, management, and outcomes of eyes with active uveitis and central serous chorioretinopathy (CSCR).

Methods: Retrospective chart review.

Results: Of 4,034 patients diagnosed with uveitis during the 8-year study period, 20 (0.5%) had comorbid active uveitis and CSCR, followed for a median of 34 months. Patients were stratified based on diagnoses sequence. In Cohort 1, 4 eyes (3 patients) initially diagnosed with active uveitis and later developed active CSCR at a median of 65 days following corticosteroid initiation, with resolution of CSCR occurring in all eyes at a median of 104 days after withdrawing corticosteroids. Three eyes (2 patients) developed worsening inflammation upon corticosteroid withdrawal requiring corticosteroid-sparing immunosuppression. In Cohort 2, 21 eyes (17 patients) with inactive CSCR were later diagnosed with active uveitis. Fifteen eyes (12 patients) were treated with corticosteroids and 9 eyes (8 patients) developed active CSCR. The CSCR persisted after corticosteroid withdrawal in 6 eyes (5 patients) necessitating targeted therapy for CSCR. The other 6 eyes (5 patients) of Cohort 2 were observed or treated with topical NSAIDS with resolution of uveitis. All patients had inactive uveitis and CSCR at final follow-up.

Conclusions: A complex relationship exists between CSCR and uveitis. Control of both diseases is possible through judicious use of corticosteroids, non-steroidal immunosuppression, and therapies targeted at persistent CSCR.

Keywords: Central Serous Chorioretinopathy; Corticosteroids; Intraocular Inflammation; Uveitis.