DR. PRIYANKA

DR MIHIKA DUBE

Abstract

40 year female presented with RE diminished vision since 2 month. She locally diagnosed RE multifocal choroiditis & treated with IVMP, oral steroid, ATT & azathioprine once daily. On examination, BCVA was 6/9 in BE. Slit lamp showed AC cells & vitreous cells 1+. Fundus showed multiple active lesion in RE and RPE change in LE. FFA showed multiple point of leakage which increased in both intensity & area in late phase in LE. RE active multifocal choroiditis with LE steroid induced CSR clinical diagnosis was made. She was advised to stop prednisolone & azathioprine increased to thrice daily. ATT continued. At 2 month, she had healing lesion in RE & resolving CSR in LE.

Conclusion- In patients with steroid induced CSR, discontinuation of steroid should be first step. The prognosis is favourable in majority of cases after stopping steroid. A high index of suspicion with appropriate clinical examination and ancillary test are mandatory to differentiate CSR from those due to uveitis.