Recurrent Central Serous Chorioretinopathy with Dexamethasone Eye Drop used Nasally for Rhinitis
A 35-year-old male, optometrist by profession, visited our hospital with complaint of seeing a dark circle in front of his right eye with onset three days prior to presentation. Patient was a non-smoker, non-alcoholic, non-hypertensive, was not on any medication and followed a healthy life style. Vision was 6/18 in the right eye with best corrected visual acuity (BCVA) of 6/6 with +2.0 D sphere. Anterior segment and intraocular pressure were normal. Fundus examination showed a bleb like elevation of retina. Fundus fluorescein angiography (FFA) showed ink blot leakage []. Coherence tomography (OCT) is shown in . The patient was diagnosed with CSC. The patient was prescribed 0.5% carboxymethylcellulose eye drops thrice a day and asked to return for follow up every two weeks. CSC completely resolved, clinically and on OCT, within seven weeks []. Four weeks later the patient had a recurrence that again resolved spontaneously over eight weeks. In all, patient had three additional episodes of CSC in the same eye over the next year []. Each time patient denied any form of corticosteroid use. After detailed questioning, he admitted, that he used dexamethasone eye drops, nasally for five to seven days before each episodes. This suggests the strong correlation between steroids given by any route and pathogenesis of CSC. This is also first case ever of confirmed CSC due to nasal intake of steroid drops.