Central Serous Chorioretinopathy after Solid Organ Transplantation
Received 23 December 2004; accepted 9 January 2006.
Purpose
To describe the demographic and clinical characteristics of central serous chorioretinopathy (CSC) after solid organ transplantation.
Design
Case series.
Participants
Fifteen patients who presented to the authors with CSC after solid organ transplantation.
Methods
We performed a retrospective chart review to identify patient demographics and clinical features of disease, including angiographic changes.
Main Outcome Measures
Patterns of CSC. These patterns were compared with type of organ received, demographics, and visual outcome.
Results
We identified 25 eyes of 7 women (46.7%) and 8 men (53.3%) that developed CSC after solid organ transplantation. Patient ages ranged from 27 to 55 years (median, 40). Seven of the 15 patients (46.7%) were Caucasian, including 3 Hispanic patients (20%). Of the 8 remaining patients (53.3%), 2 were African American (13.3%), 2 were Filipino (13.3%), and 4 were Asian (26.7%). The organs received included 13 kidneys (86.7%), 1 liver (6.7%), and 1 heart (6.7%). Systemic hypertension was reported in 14 of 15 patients (93.3%). All patients were receiving systemic immunosuppressive drugs at presentation; 14 of 15 (93.3%) were also receiving systemic corticosteroids. Visual acuity at presentation ranged from 20/20 to counting fingers. Patterns of CSC included (1) geographic or diffuse alterations in the retinal pigment epithelium (5 eyes; 2 bilateral, 1 unilateral), (2) focal CSC (6 eyes, all unilateral), (3) multifocal CSC (6 eyes; 2 bilateral, 2 unilateral), and (4) CSC with bullous retinal detachment (8 eyes, all bilateral). Follow-up, available for 21 affected eyes of 13 patients, ranged from 1 month to 6 years (median, 12 months). Compared with other solid organ transplant recipients at our institutions, renal transplant recipients (P = 0.003), as well as Hispanic and Asian patients (P = 0.05), were more prevalent in this cohort.
Conclusion
Central serous chorioretinopathy after solid organ transplantation varies in presentation and severity. Our observations support a role for choroidal vascular compromise in the pathogenesis of this disorder.
1Ocular Inflammatory Disease Center, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
2Francis I. Proctor Foundation, San Francisco, California
3Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
Correspondence to Emmett T. Cunningham, Jr, MD, PhD, Vitreous-Retina-Macula Consultants of New York, P.C., 460 Park Avenue, 5th Floor, New York, New York 10022
Manuscript no. 2004-441.
Dr Heckenlively is currently at the Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan. Dr Arroyo is currently at the Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
This work was supported in part by Research to Prevent Blindness (RPB), Inc., New York, New York (GNH, ETC); Skirball Foundation, Los Angeles, California (GNH); Vernon O. Underwood Family Endowed Professorship (JRH); and David May II Endowed Professorship (GNH). Additional support was provided by the Emily Plumb Estate and Trust Gift for resources utilized in the Jules Stein Eye Institute Clinical Research Center. Dr Holland is recipient of an RPB Physician–Scientist Award. Dr Cunningham is a recipient of an RPB Career Development Award.
ABSTRACT