Skip to main content
SpringerLink
Log in

Corticosteroids usage and central serous chorioretinopathy: a meta-analysis

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

This meta-analysis was conducted to investigate whether usage of corticosteroids was associated with an increased risk of central serous chorioretinopathy by summarizing all available evidence.

Methods

PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for all relevant studies published from inception to April 2019. Studies investigating the association between corticosteroids and the risk of central serous chorioretinopathy were included.

Results

Six case-control studies were finally included for the meta-analysis after study selection. The results of the analysis showed that there was a significantly higher risk of central serous chorioretinopathy among patients who once used corticosteroids (N = 707) compared with individuals without the usage of corticosteroids (N = 1927) (OR 4.050, 95% CI 2.270 to 7.220, I2 = 59%, P < 0.001). Results were the same for taking corticosteroids orally (OR 1.650, 95% CI 1.510 to 1.810, I2 = 47%, P < 0.001), through injection (OR 1.660, 95% CI 1.440 to 1.910, I2 = 0%, P < 0.001), and through nasal spray (OR 1.910, 95% CI 1.500 to 2.420, I2 = 17%, P < 0.001), but not for inhaled usage (OR 1.340, 95% CI 0.900 to 1.990, I2 = 0%, P = 0.160).

Conclusions

In conclusion, this meta-analysis demonstrated that patients with the usage of corticosteroids had an increased risk of central serous chorioretinopathy. Patients who were prescribed with corticosteroids need greater attention to their retina health. Also, all central serous chorioretinopathy (CSC) patients should avoid the use of corticosteroids as much as they possibly can.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Haimovici R, Koh S, Gagnon DR, Lehrfeld T, Wellik S (2004) Risk factors for central serous chorioretinopathy: a case–control study. Ophthalmology 111(2):244–249. https://doi.org/10.1016/j.ophtha.2003.09.024

    Article  PubMed  Google Scholar 

  2. Wang M, Munch IC, Hasler PW, Prünte C, Larsen M (2008) Central serous chorioretinopathy. Acta Ophthalmol 86(2):126–145

    Article  Google Scholar 

  3. Liegl R, Ulbig MW (2014) Central serous chorioretinopathy. Ophthalmologica Journal international d'ophtalmologie International journal of Ophthalmologica Zeitschrift fur Augenheilkunde 232(2):65–76. https://doi.org/10.1159/000360014

    Article  Google Scholar 

  4. Gilbert CM, Owens SL, Smith PD, Fine SL (1984) Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol 68(11):815–820

    Article  CAS  Google Scholar 

  5. Piccolino FC, De La Longrais RR, Manea M, Cicinelli S, Ravera G (2008) Risk factors for posterior cystoid retinal degeneration in central serous chorioretinopathy. Retina 28(8):1146–1150. https://doi.org/10.1097/IAE.0b013e318175421f

    Article  PubMed  Google Scholar 

  6. Kaya M, Kaya D, Idiman E (2017) Corticosteroid-associated atypical central serous chorioretinopathy in a patient with multiple sclerosis. Int J Ophthalmol 10(5):819–821. https://doi.org/10.18240/ijo.2017.05.27

    Article  PubMed  PubMed Central  Google Scholar 

  7. Geoffroy M, Afriat M, Fauconier M, Eschard JP, Salmon JH (2018) Adverse effect of corticosteroid therapy: central serous chorioretinopathy. Joint Bone Spine 85(1):127–128. https://doi.org/10.1016/j.jbspin.2017.02.001

    Article  Google Scholar 

  8. Rueda-Rueda T, Sanchez-Vicente JL, Llerena-Manzorro L, Medina-Tapia A, Gonzalez-Garcia L, Alfaro-Juarez A, Vital-Berral C, Lopez-Herrero F, Munoz-Morales A, Ortega LS, Herrador-Montiel A (2017) Bilateral exudative retinal detachment associated with central serous chorioretinopathy in a patient treated with corticosteroids. Arch Soc Esp Oftalmol 92(10):481–485. https://doi.org/10.1016/j.oftal.2017.01.002

    Article  CAS  PubMed  Google Scholar 

  9. Smuin DM, Seidenberg PH, Sirlin EA, Phillips SF, Silvis ML (2016) Rare adverse events associated with corticosteroid injections: a case series and literature review. Curr Sports Med Rep 15(3):171–176. https://doi.org/10.1249/JSR.0000000000000259

    Article  PubMed  Google Scholar 

  10. Ben Salem S, Sithom A, Ben Dhia I, Khelifi T, Askri H, Ayed A (2016) Central serous chorioretinopathy after nasal corticosteroids in the aviator. Tunis Med 94(12):893

    PubMed  Google Scholar 

  11. Valls Pascual E, Martinez-Costa L, Santander F (2015) Central serous chorioretinopathy and systemic corticosteroids in rheumatic diseases: report of three cases. BMC Musculoskelet Disord 16:378. https://doi.org/10.1186/s12891-015-0843-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Tittl MK, Spaide RF, Wong D, Pilotto E, Yannuzzi LA, Fisher YL, Freund B, Guyer DR, Slakter JS, Sorenson JA (1999) Systemic findings associated with central serous chorioretinopathy. Am J Ophthalmol 128(1):63–68

    Article  CAS  Google Scholar 

  13. Carvalho-Recchia CA, Yannuzzi LA, Negrão S, Spaide RF, Freund KB, Rodriguez-Coleman H, Lenharo M, Iida T (2002) Corticosteroids and central serous chorioretinopathy. Ophthalmology 109(10):1834–1837. https://doi.org/10.1016/S0161-6420(02)01117-X

    Article  PubMed  Google Scholar 

  14. Van Staa T, Leufkens H, Abenhaim L, Zhang B, Cooper C (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15(6):993–1000

    Article  Google Scholar 

  15. Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605

    Article  Google Scholar 

  16. Higgins JP, Green S (2011) Cochrane handbook for systematic reviews of interventions 5.1. 0. The Cochrane Collaboration:33–49

  17. Chang YS, Weng SF, Chang C, Wang JJ, Wang JY, Jan RL (2015) Associations between topical ophthalmic corticosteroids and central serous chorioretinopathy: a Taiwanese population-based study. Invest Ophthalmol Vis Sci 56(6):4083–4089. https://doi.org/10.1167/iovs.14-16360

    Article  CAS  PubMed  Google Scholar 

  18. Karadimas P, Bouzas EA (2004) Glucocorticoid use represents a risk factor for central serous chorioretinopathy: a prospective, case-control study. Graefes Arch Clin Exp Ophthalmol 242(9):800–802. https://doi.org/10.1007/s00417-004-0885-z

    Article  CAS  PubMed  Google Scholar 

  19. Mansuetta CC, Mason IJO, Swanner J, Feist RM, White MF Jr, Thomley ML, McGwin G Jr, Emond TL (2004) An association between central serous chorioretinopathy and gastroesophageal reflux disease. Am J Ophthalmol 137(6):1096–1100. https://doi.org/10.1016/j.ajo.2004.01.054

    Article  PubMed  Google Scholar 

  20. Tsai DC, Chen SJ, Huang CC, Chou P, Chung CM, Chan WL, Huang PH, Lin SJ, Chen JW, Chen TJ, Leu HB (2014) Risk of central serous chorioretinopathy in adults prescribed oral corticosteroids: a population-based study in Taiwan. Retina 34(9):1867–1874. https://doi.org/10.1097/iae.0000000000000159

    Article  CAS  PubMed  Google Scholar 

  21. Bouzas EA, Karadimas P, Pournaras CJ (2002) Central serous chorioretinopathy and glucocorticoids. Surv Ophthalmol 47(5):431–448

    Article  Google Scholar 

  22. da Silva FT, Hirata CE, Sakata VM, Olivalves E, Preti R, Pimentel SLG, Gomes A, Takahashi WY, Costa RA, Yamamoto JH (2012) Indocyanine green angiography findings in patients with long-standing Vogt-Koyanagi-Harada disease: a cross-sectional study. BMC Ophthalmol 12. https://doi.org/10.1186/1471-2415-12-40

  23. Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D (1994) Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 112(8):1057–1062

    Article  CAS  Google Scholar 

  24. Bill A, Sperber G (1990) Control of retinal and choroidal blood flow. Eye 4(2):319

    Article  Google Scholar 

  25. Gemenetzi M, De Salvo G, Lotery AJ (2010) Central serous chorioretinopathy: an update on pathogenesis and treatment. Eye (Lond) 24(12):1743–1756. https://doi.org/10.1038/eye.2010.130

    Article  CAS  Google Scholar 

  26. Hadcock JR, Malbon CC (1988) Regulation of beta-adrenergic receptors by “permissive” hormones: glucocorticoids increase steady-state levels of receptor mRNA. Proc Natl Acad Sci 85(22):8415–8419

    Article  CAS  Google Scholar 

  27. Sakaue M, Hoffman BB (1991) Glucocorticoids induce transcription and expression of the alpha 1B adrenergic receptor gene in DTT1 MF-2 smooth muscle cells. J Clin Invest 88(2):385–389

    Article  CAS  Google Scholar 

  28. Makara GB, Haller J (2001) Non-genomic effects of glucocorticoids in the neural system: evidence, mechanisms and implications. Prog Neurobiol 65(4):367–390

    Article  CAS  Google Scholar 

  29. Mann R, Riva C, Stone R, Barnes G, Cranstoun S (1995) Nitric oxide and choroidal blood flow regulation. Invest Ophthalmol Vis Sci 36(5):925–930

    CAS  PubMed  Google Scholar 

  30. Prünte C, Flammer J (1996) Choroidal capillary and venous congestion in central serous chorioretinopathy. Am J Ophthalmol 121(1):26–34

    Article  Google Scholar 

  31. Araque K, McGlotten RN, Nieman LK (2017) Cushing's syndrome and the development of central serous chorioretinopathy. Experience at the national institutes of health. Endocr Rev 38(3)

  32. Bouzas EA, Scott MH, Mastorakos G, Chrousos GP, Kaiser-Kupfer MI (1993) Central serous chorioretinopathy in endogenous hypercortisolism. Arch Ophthalmol 111(9):1229–1233

    Article  CAS  Google Scholar 

  33. Chalisgaonkar C, Chouhan S, Lakhtakia S, Choudhary P, Dwivedi PC, Rathore MK (2010) Central serous chorioretinopathy and endogenous cortisol-is there an association. Indian J Ophthalmol 58(5):449–450. https://doi.org/10.4103/0301-4738.67055

    Article  PubMed  PubMed Central  Google Scholar 

  34. Garg SP, Dada T, Talwar D, Biswas NR (1997) Endogenous cortisol profile in patients with central serous chorioretinopathy. Br J Ophthalmol 81(11):962–964

    Article  CAS  Google Scholar 

  35. Esfahani MR, Torabi HR, Harandi ZA, Zarei M (2010) Ketoconazole in the treatment of central serous chorioretinopathy. Iran J Ophthalmol 22(4):59–65

    Google Scholar 

  36. Golshahi A, Klingmueller D, Holz FG, Eter N (2010) Ketoconazole in the treatment of central serous chorioretinopathy: a pilot study. Acta Ophthalmol 88(5):576–581. https://doi.org/10.1111/j.1755-3768.2008.01467.x

    Article  PubMed  Google Scholar 

  37. Meyerle CB, Freund KB, Bhatnagar P, Shah V, Yannuzzi LA (2007) Ketoconazole in the treatment of chronic idiopathic central serous chorioretinopathy. Retina 27(7):943–946

    Article  Google Scholar 

  38. Fardin B, Weissgold DJ (2002) Central serous chorioretinopathy after inhaled steroid use for post-mycoplasmal bronchospasm [4]. Br J Ophthalmol 86(9):1065–1066. https://doi.org/10.1136/bjo.86.9.1065

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Haimovici R, Gragoudas ES, Duker JS, Sjaarda RN, Eliott D (1997) Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids. Ophthalmology 104(10):1653–1660

    Article  CAS  Google Scholar 

Download references

Funding

This study is funded by the National Natural Science Foundation of China (no. 81271019) and the Sichuan Provincial Science, Technology Support Project (no. 2019YJ0129), and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (no. Z2018B22).

Author information

Author notes

  1. Ge Ge and Yun Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, China

    Ge Ge & Yun Zhang

  2. West China School of Medicine of Sichuan University, Chengdu, 610041, China

    Yichi Zhang & Zhihui Xu

  3. Department of Ophthalmology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China

    Meixia Zhang

Authors
  1. Ge Ge
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yichi Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhihui Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meixia Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Meixia Zhang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ge, G., Zhang, Y., Zhang, Y. et al. Corticosteroids usage and central serous chorioretinopathy: a meta-analysis. Graefes Arch Clin Exp Ophthalmol 258, 71–77 (2020). https://doi.org/10.1007/s00417-019-04486-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-019-04486-w

Keywords

Search

Navigation