Retinal pigment epithelial changes associated with systemic corticosteroidtreatment

Background: It is well known that topical as well as systemic treatment wit h corticosteroids may have ocular side effects. The most common are the dev elopment of cataract and increase of intraocular pressure, however, alterat ion of the retinal pigment epithelium may also occur. Patient: A 64-year old male experienced a progressive decrease of visual ac uity over a time period of 6 weeks. Ophthalmologic examination revealed a s evere diffuse retinal pigment epitheliopathy with serous detachment of the neurosensory retina. This patient was treated with systemic methylprednisol one for chronic glomerulonephritis. After cessation of the treatment with s ystemic corticosteroids visual acuity improved and the serous retinal detac hment resolved. Conclusion: Ophthalmologic examination including biomicroscopy of the retin a is recommended on a regular basis for patients treated with systemic cort icosteroids. With development of pigment epithelial changes steroids should be reduced or discontinued if possible.