Premium
Central serous chorioretinopathy misdiagnosed as posterior uveitis: frequency and consequences
Author(s) -
PAPADIA M,
HERBPRT CP
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.2846.x
Subject(s) - medicine , uveitis , serous fluid , indocyanine green angiography , ophthalmology , dermatology , medical diagnosis , intermediate uveitis , differential diagnosis , fluorescein angiography , visual acuity , radiology , pathology , anterior uveitis
Purpose Central serous chorioretinopathy (CSC) is one of the differential diagnoses to be kept in mind in case of posterior uveitis. Its diagnosis is of utmost importance as CSC misdiagnosed as posterior uveitis can worsen related to the prescription of corticosteroid therapy. The purpose of this study was to determine the proportion of cases of CSC misdiagnosed as a posterior uveitis. Methods Charts of patients seen in the section of inflammatory eye diseases at the Centre for Opththalmic Specialised Care (COS) in Lausanne, Switzerland seen from 1995 to 2011 were reviewed and referred cases of CSC misdiagnosed as posterior uveitis were studied. Results In a collective of 1268 patients seen from 1995 to 2011 at the COS, 12 patients (0.95%) with CSC were misdiagnosed as posterior uveitis. Erroneous diagnoses were Ocular tuberculosis in 3 cases, Vogt‐Koyanagi‐Harada disease in 2 cases, lupus (LED) in one case and undetermined uveitis in 3 cases. In 3 cases CSC developed following corticosteroid therapy for uveitis (2) or systemic inflammatory disease (1) and was misdiagnosed as worsening of the underlying inflammatory disease. Bad functional outcome was proportional to the diagnostic delay of CSC. The most useful means to diagnose CSC retrospectively was either the original angiography, especially indocyanine green angiography (ICGA), or OCT. Conclusion CSC is not a rare misdiagnosis in posterior uveitis representing a percentage of nearly 1% in a total collective of uveitis cases but reaching a proportion of about 3% when only posterior uveitis cases are considered. Investigative methods such as angiography including ICGA, and OCT are crucial for reaching a diagnosis as quickly as possible to avoid disease worsening corticosteroid therapy.