A 32-year-old man with a recent flare-up of eczema was started on oral prednisolone. Two weeks later he develops blurred vision in one eye. OCT shows serous neurosensory detachment at the macula with subretinal fibrin. Which statement about his condition is correct?

• A Oral corticosteroids should be continued at a higher dose to hasten resolution
• B Corticosteroids are a recognized precipitant and should be stopped ✓
• C Immediate intravitreal anti-VEGF injection is first-line therapy
• D Urgent retinal detachment surgery is indicated

Explanation

Central serous chorioretinopathy is strongly associated with exogenous corticosteroid exposure, whether systemic, inhaled, topical, or perioperative, acting through glucocorticoid-mediated choroidal hyperpermeability. The correct action is to withdraw the steroid where feasible, since most cases resolve spontaneously over weeks to months. Anti-VEGF injections treat choroidal neovascularization, not CSCR, and there is no rhegmatogenous break here, so detachment surgery has no role. Photodynamic therapy is reserved for chronic or persistent cases.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.