Intravitreal injection of triamcinolone for diffuse macular edema.
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Biomedical subjects
Publications and source records attributed to Hanna Rodriguez-Coleman.
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PURPOSE: To describe a case of spontaneous resolution of bilateral stage 1 macular holes documented using optical coherence tomography. DESIGN: Observational case report. METHODS: A patient presented with blurring and distortion in the right eye. Optical coherence tomography showed a stage 1 macular hole manifested as a foveal pseudocyst. The left eye appeared normal. RESULTS: On 6-month follow-up, symptoms had resolved in the right eye but had developed in the left eye. Optical coherence tomography revealed normal anatomy in the right eye with a foveal pseudocyst in the left eye. At 10 months, the patient was asymptomatic and had normal foveal anatomy in both eyes on optical coherence tomography. CONCLUSION: Stage 1 macular holes may appear as foveal pseudocysts on optical coherence tomography. In such cases, optical coherence tomography can provide definitive diagnostic information when clinical examination is equivocal. The observation and spontaneous resolution of bilateral stage 1 holes documented by optical coherence tomography are unique and interesting events of which a MEDLINE search found no previous reports.
PURPOSE: The purpose of this study is to investigate the relationship between corticosteroid use and central serous chorioretinopathy (CSC). DESIGN: A prospective, case-controlled study. PARTICIPANTS AND CONTROLS: A consecutive series of patients with acute manifestations of CSC and a control group matched for age, race, and gender were recruited between January 2000 and July 2000. METHODS: A detailed clinical history was taken, and fundus examination with slit-lamp biomicroscopy was performed on all patients. Fluorescein angiography was obtained on the study patients. RESULTS: A total of 50 patients was recruited. Twenty-six patients (52%) had a history of exogenous steroid use, including oral, intravenous, intranasal, and intraarticular administration. Two additional patients had a history of endogenous hypercortisolism (Cushing's syndrome). In a matched control group, eight patients (18%) had a history of steroid use. The difference in corticosteroid exposure between study patients and controls was statistically significant (P < 0.0001). MAIN OUTCOME MEASURES: History of corticosteroid use or Cushing's syndrome. CONCLUSIONS: This study is consistent with previous reports associating steroid use with CSC. It identifies corticosteroids as a significant risk factor for the development of acute, exudative macular manifestation and implicates hypercortisolism as a factor in the pathogenesis of this disorder. Several forms of corticosteroid administration were observed to be a risk factor for CSC. Accordingly, susceptible patients in need of corticosteroids should be advised of the risk of developing acute manifestations of CSC.
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