Steroid-Induced Central Serous Chorioretinopathy in Uveitis: Diagnostic Challenges and Multimodal Imaging with a Primary Inflammatory Choriocapillaropathy Illustrative Case.

Background and Clinical Significance. Steroid-induced central serous chorioretinopathy (CSCR) is a potential complication in patients with uveitis receiving corticosteroid therapy and may be misinterpreted as persistent inflammatory activity. Inflammatory and iatrogenic subretinal fluid may coexist, particularly in primary inflammatory choriocapillaropathies (PICCPs), creating diagnostic and therapeutic challenges. This narrative review discusses the pathophysiological mechanisms underlying steroid-induced CSCR and emphasizes the value of multimodal imaging in distinguishing inflammatory subretinal fluid from steroid-induced serous retinal detachment. Optical coherence tomography, fundus autofluorescence, fluorescein angiography and indocyanine green angiography provide complementary information that may guide accurate diagnosis and avoid inappropriate corticosteroid escalation. Case Presentation. An illustrative case of ampiginous choroiditis, a severe form of PICCP, complicated by bilateral steroid-induced CSCR shortly after initiation of high-dose corticosteroid therapy, is presented to highlight the clinical relevance of this complication and its therapeutic implications. Conclusions. Early recognition through multimodal imaging enabled prompt corticosteroid tapering and introduction of steroid-sparing immunosuppression, with subsequent marked anatomical and functional improvement.