REDUCTION OF SCLERAL THICKNESS WITH TOPICAL FLUOROMETHOLONE IN MANAGEMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY COMPLICATED BY POSTERIOR CYSTOID DEGENERATION.

PURPOSE: To describe the role of topical fluorometholone in the treatment of eyes with central serous chorioretinopathy complicated by posterior cystoid degeneration.

METHODS

Patients with posterior cystoid degeneration associated with central serous chorioretinopathy were prospectively recruited, examined with multimodal imaging, and prescribed for topical fluorometholone four times daily. Eyes with macular neovascularization were excluded based on optical coherence tomography angiography. Spectral-domain optical coherence tomography was used to monitor central retinal thickness, subfoveal choroidal thickness, and the thickness of the anterior sclera.

RESULTS

Five eyes of four patients were included. Intraretinal and subretinal fluid in all eyes had been unresponsive to all standard treatments, but improved remarkably or completely resolved with limited improvement of visual acuity after a mean of 6.0 ± 2.0 weeks of topical fluorometholone administration. In all cases, significant reduction of scleral thickness was observed with no or mild intraocular pressure rise.

CONCLUSION

Severe cases of central serous chorioretinopathy complicated by posterior cystoid degeneration associated with vision loss may be managed with topical fluorometholone. The positive effects of steroids in central serous chorioretinopathy may be mediated by their effects on reduction of the scleral thickness.