A 44-year-old male, known hypertensive, diabetic, and compensated cirrhotic (presumably alcohol-induced) for the last 10 years. He presented with acute decompensation and was investigated. The diagnosis on admission was multisystem microvascular dysfunction in decompensated cirrhosis with diabetic nephropathy. His unaided visual acuity was 6/12 in the right and 6/21 in the left. Near vision was N8 and N12 in the right and left eyes. He underwent an optical coherence tomography (OCT), which revealed subretinal fluid consistent with central serous retinopathy bilaterally. He underwent living donor liver transplantation and received methylprednisolone and basiliximab. Subsequently, he developed transient visual blurring with a reduction in his visual acuity to 6/24 bilaterally and a best-corrected near visual acuity of N18, N24, respectively. A repeat OCT (30 days after the initial scan) revealed a markedly increased subretinal fluid bilaterally. We postulate that the use of systemic steroids led to this exacerbation.
Mehta et al. (Wed,) studied this question.