Intravitreal steroid-associated central serous chorioretinopathy

Central serous chorioretinopathy (CSC) is a known side effect of systemic steroid therapy. The role of intravitreal steroids in causing CSC is controversial. We present two cases of acute CSC that developed after intravitreal steroid injections. One was a case of diabetic macular oedema; another was a case of branch retinal vein occlusion-related macular oedema. Both cases showed complete resolution of cystoid oedema after intravitreal triamcinolone acetonide injection, but there was a progressive increase in neurosensory detachment (NSD), leading to a suspicion of CSC. Fundus fluorescein angiography confirmed the diagnosis. The first case was treated with focal laser, and the second one was treated with oral eplerenone. There was complete resolution of NSD in both cases. This report adds to the evidence that intravitreal steroids can indeed cause acute CSC. A high index of suspicion for CSC should be maintained in cases where NSD increases following intravitreal steroid administration.