Incidence, Management, and Outcomes of Eyes with Comorbid Active Uveitis and Central Serous Chorioretinopathy.

Abstract

To investigate the incidence, management, and outcomes of eyes with active uveitis and central serous chorioretinopathy (CSCR). Retrospective chart review. Of 4,034 patients diagnosed with uveitis during the 8-year study period, 20 (0.5%) had comorbid active uveitis and CSCR, followed for a median of 34 months. Patients were stratified based on diagnoses sequence. In Cohort 1, 4 eyes (3 patients) initially diagnosed with active uveitis and later developed active CSCR at a median of 65 days following corticosteroid initiation, with resolution of CSCR occurring in all eyes at a median of 104 days after withdrawing corticosteroids. Three eyes (2 patients) developed worsening inflammation upon corticosteroid withdrawal requiring corticosteroid-sparing immunosuppression. In Cohort 2, 21 eyes (17 patients) with inactive CSCR were later diagnosed with active uveitis. Fifteen eyes (12 patients) were treated with corticosteroids and 9 eyes (8 patients) developed active CSCR. The CSCR persisted after corticosteroid withdrawal in 6 eyes (5 patients) necessitating targeted therapy for CSCR. The other 6 eyes (5 patients) of Cohort 2 were observed or treated with topical NSAIDS with resolution of uveitis. All patients had inactive uveitis and CSCR at final follow-up. A complex relationship exists between CSCR and uveitis. Control of both diseases is possible through judicious use of corticosteroids, non-steroidal immunosuppression, and therapies targeted at persistent CSCR.