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Purpose: To describe the possible association between central serous chorioretinopathy (CSCR) and desmopressin use. Methods: The case histories of 2 middle-aged men with CSCR using desmopressin nasal spray were studied. Results: The diagnosis of CSCR was made on the basis of clinical features and ancillary testing (fluorescein angiography and optical coherence tomography). Both patients were using desmopressin nasal spray for polyuria when they developed the first ocular symptoms. Both of them also had an independent risk factor for developing CSCR. Conclusion: We suggest that desmopressin-induced hypercortisolism might implicate the development of CSCR in some patients. A larger study on patients using desmopressin nasal spray would be beneficial to confirm the possible association between this form of therapy and the development of CSCR.

Perforations of the nasal septum have many etiologies and occasionally result from intranasal medicated spray use. This case report describes a perforation related to the use of desmopressin nasal spray, which has not been previously reported in the literature. Clinical considerations presented in this article include appropriate technique of nasal spray application, appropriate monitoring of patients on intranasal sprays, and indications for evaluation by an otolaryngologist. Septal perforation treatment success is improved with an early diagnosis.

Hemophilia is mostly an inherited genetic disorder, caused by mutations in the clotting factor gene. With the available treatment options, life expectancy of a hemophilic patient is usually of that of the general population. Hence, it is not uncommon that they present for surgical procedures. However, hemophilic patients for the major surgical procedure are always a real challenge for the perioperative physician. We have recently encountered one such patient who was hospitalized with acute paraplegia due to a mass lesion of spine and successfully managed with the recovery of motor power. His pre-operative Factor VIII level was 0. Desmopressin nasal spray has a limited role in severe hemophilic. Our main concern was effective replacement therapy and maintenance of desired Factor VIII levels not only during surgery but also in the immediate post-operative period.

On March 3, 2017, the US Food and Drug Administration (FDA) approved desmopressin nasal spray (Noctiva) for the “treatment of nocturia due to nocturnal polyuria in adults who awaken at least 2 times per night to void.”1 According to the product manufacturer, Serenity Pharmaceuticals, nocturia is a common condition affecting “over 89 million adults in the U.S.”