Central Serous Chorioretinopathy Redux
John R Martinelli MD OD FAAO
Teaching The Fine Art of Patient Management
Sometimes personality really doesn't matter...
Central Serous Chorioretinopathy (CSC) has long been associated with younger stressed-out males & Type A personalities - likely due to higher circulating cortisol levels being released via the adrenals. Exogenous corticosteroid use has also been a main concern, however, there is a more complex pharmacological landscape for us to understand.
We should be aware several other drug classes may contribute to CSC development or exacerbation. Antihypertensive medications, particularly those affecting the renin-angiotensin system, have been linked to CSC in some individuals. Phosphodiesterase inhibitors, commonly prescribed for erectile dysfunction, may increase risk through their effects on choroidal blood flow. Sympathomimetic agents, found in decongestants and some weight loss medications, have also been implicated by potentially altering choroidal vascular dynamics. Additionally, certain antihistamines have been linked, although the mechanism remains unclear.
Our understanding of other pharmacological associations matters for comprehensive evaluations. This is a reminder to always review our patients medication and look beyond personalities or corticosteroids. Our broader perspective can allow for more effective management potentially improving outcomes.
-JRM
Go to the article in Survey of Ophthalmology HERE.
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