Systemic Steroid Therapy for Serous Retinal Detachment Caused by Excessive Endolaser during Diabetic Retinopathy Surgery

PURPOSE: To report cases of macular serous retinal detachment caused by excessive intraoperative endolaser in patients with diabetic vitreous hemorrhage. Macular serous retinal detachment was improved by systemic steroid therapy. CASE SUMMARY: A 64-year-old male (case 1) and a 67-year-old female (case 2) treated with vitrectomy and endolaser (case 1, 3,184 shots; case 2, 1,734 shots) because of diabetic vitreous hemorrhage visited our out-patient clinic with blurred vision. Best corrected visual acuity (BCVA) in case 1 was hand motion and 0.03 in case 2. Fundus examination and optical coherence tomography (OCT) revealed extensive subretinal fluid accumulation of the posterior pole. With the diagnosis of macular serous retinal detachment caused by excessive intraoperative endoaser, oral steroid (40 mg/qd, 5 days) was administered and then later reduced in case 1. In case 2, we administered intravenous high-dose steroid (250 mg/qid, 3 days). After systemic steroid therapy, BCVA was improved to 20/30 in case 1 and 20/40 in case 2 and OCT showed the subretinal fluid was resolved. CONCLUSIONS: During diabetic retinopathy surgery, excessive endolaser induced macular serous retinal detachment and systemic steroid therapy was necessary in diabetic patients. Thus, physicians should be well acquainted with this complication.

Steroid-induced Central Serous Retinopathy—A Case Report

Long-term, high-dose corticosteroid therapy is well-known to cause systemic and ocular complications. A lesser known complication is chronic central serous chorioretinopathy (CSCR). Although idiopathic central serous chorioretinopathy (CSR) is known to be mild with spontaneous recovery and minimal effects on the final visual acuity, chronic CSCR as a complication of long-term steroid therapy behaves differently, and may cause irreversible visual impairment.

A Case of Ciliary Body Tuberculoma Causing Sclera Melting

PURPOSE: To report a case of ciliary body tuberculoma, which induced scleral melting. CASE SUMMARY: A 32-year-old man, who was diagnosed with miliary pulmonary tuberculosis 1 week earlier, presented with a conjunctival injection and mass on his right eye 3 months in duration. On excisional biopsy, melted sclera and exposed uveal tissue were found; acid-fast stain was positive. Two months after anti-tuberculosis treatment, anterior granulomatous uveitis and granuloma formation on the anterior chamber angle developed. A low-dose systemic steroid therapy was added. Six weeks after systemic steroid therapy, anterior uveitis and granuloma on anterior chamber angle disappeared. CONCLUSIONS: We experienced a case of ocular tuberculosis on the ciliary body. A low-dose systemic steroid along with multi-drug anti-tubercular therapy may be an effective treatment of ciliary body tuberculoma.

The Effect of Systemic Steroid Therapy on Dry Eye in Hematopoietic Stem Cell Transplantated Patients

PURPOSE: To evaluate the effects of systemic steroid therapy on the development of dry eye syndrome (DES) in graft-versus-host disease (GVHD) resulting from hematopoietic stem cell transplantation (HSCT) in hematologic malignancy (HM) patients. METHODS: We analyzed 108 HSCT patients. We measured tear film break up time (BUT) and basal tear secretion, and checked for corneal lesions. BUT under 10 seconds and basal tear secretion under 10 mm gave a diagnosis of DES. Significant corneal lesions were also described in this gorup. We compared the clinical aspect and frequency of dry eye according to GVHD and also compared clinical aspects of dry eye in GVHD patients before and after systemic steroid therapy. RESULTS: Fifty-six patients (51.9%) developed GVHD, including 51 patients (91.1%) in the GVHD group and 31 patients (59.6%) in the non-GVHD group. The frequency of DES was statistically significant in the GVHD group (p0.05). CONCLUSIONS: The severity and frequency of DES were high in the GVHD group. At the same time, systemic steroid therapy could relieve DES in GVHD patients. Therefore, proper medical treatment and ocular examinations should be performed for HSCT patients.

Pyomyositis Developed during Systemic Steroid Therapy for Cutaneous Leukocytoclastic Vasculitis / 대한피부과학회지

Pyomyositis is an acute, suppurative bacterial infection of striated muscle. It occurs primarily, and not from contiguous infection. It is considered rare in temperate climates. There has been no report of pyomyositis in the Korean dermatologic literature to date. We report a case of pyomyositis which developed in a 53-year-old male. The patient was admitted for the treatment of cutaneous leukocytoclastic vasculitis on his entire body. He was treated with oral corticosteroids for approximately three weeks. The skin condition did show improvement; however, the patient developed a persistent fever and a newly-found mass on the right upper back. The mass was diagnosed as an abscess, replacing the striated muscles of the back by sono-guided needle aspiration. After surgical intervention and IV antibiotic treatment, the symptoms and mass on the back disappeared. We speculate that the underlying skin condition and long-term use of oral corticosteroids predisposed the patient to pyomyositis.