Literature DB >> 31238489

Comment: Clinical profile of uveitis patients developing central serous chorioretinopathy - An experience at a tertiary eye care center in India.

Aditya Aseem1, Kushagra Jain1, Naresh Kumar Yadav1, Ramesh Venkatesh1.   

Abstract

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Year:  2019        PMID: 31238489      PMCID: PMC6611249          DOI: 10.4103/ijo.IJO_331_19

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   1.848


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Dear Sir, We read with great interest the article by Majumder et al.,[1] titled “Clinical profile of uveitis patients developing central serous chorioretinopathy: An experience at a tertiary eye care center in India.” In this paper, the authors have described the demographic and clinical features of central serous chorioretinopathy (CSCR) in eyes with previously diagnosed cases of uveitis. However, we have a few comments to make. The two main factors responsible for the development of CSCR in uveitic patients are use of long-term corticosteroids (all routes)[23] and inflammation itself leading to the breakdown of the blood–retinal barrier and increased choroidal hyperpermeability. Also, in cases of long-standing uveitis, the retinal pigment epithelium becomes dysfunctional leading to the poor absorption of the overlying subretinal fluid. With these mechanisms in mind, the authors have not addressed certain important aspects regarding the disease in their methodology or discussion. There is no mention in the paper regarding the mean duration of corticosteroid usage for developing CSCR, presence of unilateral/bilateral uveitis, whether the CSCR affected the same eye as the uveitis or fellow eye, was the uveitis active/inactive at the time of development of CSCR, and was the patient a known case of CSCR before the development of uveitis. All these factors are important and would play an important role in deciding the management of both uveitis and CSCR. Also, the presence of multiple leaks on fluorescein angiography could confuse other conditions like Vogt–Koyanagi–Harada syndrome, sympathetic ophthalmia, and posterior scleritis with CSCR.[4] Identification of pigment epithelial detachment on optical coherence tomography would tilt the diagnosis more in favor of CSCR in cases of dilemma. Hence, to conclude, the presence of CSCR in uveitic eyes is always challenging in terms of diagnosis and formulating treatment strategy for both uveitis and CSCR.

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  4 in total

Review 1.  Central serous chorioretinopathy and glucocorticoids: an update on evidence for association.

Authors:  Benjamin P Nicholson; Elizabeth Atchison; Amrou Ali Idris; Sophie J Bakri
Journal:  Surv Ophthalmol       Date:  2017-06-30       Impact factor: 6.048

2.  Localized topical steroid use and central serous retinopathy.

Authors:  Lauren Y Chan; Robert S Adam; David N Adam
Journal:  J Dermatolog Treat       Date:  2016-01-29       Impact factor: 3.359

3.  Central Serous Chorioretinopathy Misdiagnosed as Posterior Uveitis and the Vicious Circle of Corticosteroid Therapy.

Authors:  Marina Papadia; Bruno Jeannin; Carl P Herbort
Journal:  J Ophthalmic Vis Res       Date:  2015 Jul-Sep

4.  Clinical profile of uveitis patients developing central serous chorioretinopathy: An experience at a tertiary eye care center in India.

Authors:  Parthopratim Dutta Majumder; Nitin Menia; Sridharan Sudharshan; Chetan Rao; Sudha K Ganesh; Jyotirmay Biswas
Journal:  Indian J Ophthalmol       Date:  2019-02       Impact factor: 1.848

  4 in total
  1 in total

1.  Response to comments on: Clinical profile of uveitis patients developing central serous chorioretinopathy - An experience at a tertiary eye care center in India.

Authors:  Parthopratim Dutta Majumder; Nitin Menia; Sridharan Sudharshan; Chetan Rao; Sudha K Ganesh; Jyotirmay Biswas
Journal:  Indian J Ophthalmol       Date:  2020-01       Impact factor: 1.848

  1 in total

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