Changes in Choroidal Thickness After Systemic Administration of High-Dose Corticosteroids: A Pilot Study

Abstract

PURPOSE. To characterize the effects of corticosteroids on choroidal thickness, we measured the choroid thickness in patients treated systemically with a high-dose corticosteroid.METHODS. A prospective, pilot study was conducted on 20 patients who required high-dose corticosteroid pulse therapy (>500 mg/d). Choroidal thickness was measured at baseline, 1 day, 1 week, and 1 month after corticosteroid administration. Blood pressure was measured four times a day for the first 5 days of steroid treatment.RESULTS. This study ultimately included 35 eyes from 18 patients. Each patient was treated with high-dose corticosteroid therapy at a concentration of 19.5 +/- 4.1 mg per kg body weight for 5.2 +/- 1.1 days. Mean subfoveal choroidal thickness at baseline was 259.8 mu m (range, 86.4-394.7 mu m). Choroidal thickness showed no significant change at 1 day, 1 week, or 1 month after corticosteroid administration (P = 0.197). Mean systolic blood pressure increased by 13 mmHg (P = 0.008), but diastolic pressure did not change (P = 0.117). One patient (5.6%) who had presented with pigment epithelial detatchment (PED) and thick choroid (381.1 lm) developed bilateral focal subretinal fluid during the study and showed central serous chorioretinopathy (CSC) with a 13.1% increase in subfoveal choroidal thickness.CONCLUSIONS. No consistent changes in choroidal thickness were observed after systemic highdose corticosteroid treatment, but one patient with PED and thick choroid showed an increase in choroidal thickening as well as features of CSC. Thus, steroid-induced CSC may be an idiosyncratic response in selected vulnerable individuals rather than a dose-dependent effect.