Central serous chorioretinopathy, corticosteroids, and uveitis.

Any patient with a diagnosis of central serous chorioretinopathy (CSCR) should be questioned to determine any recent corticosteroid use, as the poor visual outcome may be due to unrecognized corticosteroid use. Atypical forms of CSCR may be misdiagnosed as an inflammatory serous retinal detachment, mainly Vogt-Koyanagi-Harada disease. CSCR that develops in association with preexisting uveitis could be a challenging diagnosis as it might be misinterpreted as a worsening of the primary inflammatory condition. Failure to differentiate CSCR from retinal or choroidal inflammatory diseases may result in inappropriate use of corticosteroids, leading to exacerbation of the condition and permanent visual loss. Discontinuation of corticosteroids should be the first step in the treatment of CSCR associated with corticosteroid therapy, and the use of immunosuppressive or immunomodulatory drugs may be required to control systemic or ocular inflammatory disease. The prognosis is usually favorable, but persistent visual loss may occur.