Central serous chorioretinopathy following intravenous steroid therapy for retrobulbar optic neuritis - "Treatment dilemma" - Case report and review of literature

The adverse reactions of high-dose exogenous steroid administration are well documented, and central serous chorioretinopathy (CSCR) is one among them. Steroid-induced CSCR has a different clinical profile when compared to idiopathic CSCR and poses a unique clinical challenge, especially when encountered during the management of posterior-segment inflammation such as optic neuritis and posterior uveitis. The clinical course of steroid-induced CSCR is variable and is not dose dependent. Management options include observation, cessation of steroids when permissible, focal laser, photodynamic therapy, and switching to alternative immunosuppressive therapy. We describe a case of steroid-induced recurrent bilateral CSCR during the treatment of unilateral isolated retrobulbar neuritis in a young male, its clinical course, and management. Our case emphasizes the importance of obtaining prior informed consent explaining the possible side effects of high-dose steroid therapy, and documentation is very important for the management of these complex case scenarios.