Teaching NeuroImages: Central Serous Chorioretinopathy After Corticosteroid Treatment for Optic Neuritis

A 37-year-old woman presented with a 1-week history of painful vision loss in both eyes from optic neuritis. She was treated with intravenous, followed by oral corticosteroids. After she completed intravenous corticosteroids, she developed a new area of blurred vision inferiorly (right eye) and centrally (left eye) secondary to central serous chorioretinopathy (CSCR), which resolved after oral prednisone taper (figure). CSCR is characterized by well-circumscribed serous detachments of the retina and is typically seen after exogenous corticosteroid use. CSCR can be misdiagnosed as optic neuritis(1) or develop in patients with optic neuritis after corticosteroid treatment(2) and should be kept in the differential diagnosis for worsening vision after corticosteroids.

Automated summary

A 37-year-old female presented with painful vision loss in both eyes due to optic neuritis, which was followed by central serous chorioretinopathy after corticosteroid treatment. The CSCR resolved after oral prednisone taper. CSCR can be misdiagnosed as optic neuritis or develop in patients with optic neuritis after corticosteroid treatment, and should be considered in cases of worsening vision after corticosteroid therapy.