Autoimmune thyroiditis and central serous chorioretinopathy may have a relation

Central serous chorioretinopathy: Pathophysiology, systemic associations, and a novel etiological classification

Central serous chorioretinopathy (CSC) has remained an enigmatic disease since its initial description by Von Graefe. Over the years, multiple risk factors have been recognized: these include psychological stress, behavioral traits, and corticosteroids. The basic pathophysiology of CSC involves choroidal thickening, vascular congestion, altered choroidal blood flow (ChBF), and choroidal hyperpermeability, leading to retinal pigment epithelium decompensation and subsequent neurosensory detachment. Multiple organ systems, mainly the nervous, cardiovascular, endocrinal, and renal systems participate in the control of the vascular tone and the ChBF via hypothalamus-pituitary-adrenal axis and renin-angiotensin-aldosterone system, while others such as the hepatic system regulate the enzymatic degradation of corticosteroids. Many vasoactive and psychotropic drugs also modulate the ocular perfusion. In addition, there are anatomical and genetic predispositions that determine its progression to the chronic or recurrent form, through cellular response and angiogenesis. We herein review the basic pathophysiology and immunogenetics in CSC along with the role of multiple organ systems. With this background, we propose an etiological classification that should provide a framework for customized therapeutic interventions.

Can Hypothyroidism Cause Acute Central Serous Chorioretinopathy?

Purpose: To evaluate selected systemic findings, especially thyroid functions, in acute central serous chorioretinopathy (CSC) patients.Materials and Methods: In all, 71 consecutive acute CSC patients who fulfilled the inclusion criteria and 70 age-matched healthy control subjects were included in the study. Systemic findings, including serum levels of thyroid hormones, thyroid stimulating hormone (TSH), mean arterial pressure (MAP), pulse rate, serum lipid levels and optical coherence tomography findings, were compared between the groups. Independent samples t-test was used for statistical analysis.Results: The mean ages of the CSC and control groups were 41.06 ± 6.49 and 40.06 ± 7.08 years old, respectively. Retinal thickness, choroidal thickness, TSH levels, pulse rate and MAP were significantly different between CSC patients and healthy control subjects (range of p values: <0.001-0.042). In the logistic regression analysis, MAP, serum triglyceride concentration and central choroidal thickness were positively associated with CSC (range of p values: <0.001-0.035).Conclusion: Acute CSC patients had significantly higher pulse rates and MAP and significantly thicker choroidal thickness than were found in healthy subjects. TSH levels were also significantly higher in CSC patients than in controls. Hence, hypothyroidism might be associated with CSC.