A patient with documented central serous chorioretinopathy asks about medications. Which drug class should be avoided because it can precipitate or worsen the disease?

• A Metformin
• B Oral antihistamines
• C Beta blockers
• D Systemic corticosteroids ✓

Explanation

Systemic corticosteroid exposure, whether therapeutic or endogenous as in Cushing syndrome, is an established risk factor for central serous chorioretinopathy and should be avoided or minimized in affected patients. Corticosteroids are thought to act on choroidal vascular receptors and worsen the hyperpermeability driving subretinal fluid accumulation. Most acute episodes resolve spontaneously within a few months, so observation is appropriate unless vision remains poor beyond that period. Antihistamines, beta blockers and metformin have no such association.

Reference: Kanski's Clinical Ophthalmology, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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