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Jain M, Mohan S, van Dijk EHC. Central serous chorioretinopathy: Pathophysiology, systemic associations, and a novel etiological classification. Taiwan J Ophthalmol 2022; 12:381-393. [PMID: 36660127 PMCID: PMC9843580 DOI: 10.4103/2211-5056.362601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/04/2022] [Indexed: 12/08/2022] Open
Abstract
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.
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Affiliation(s)
- Manish Jain
- Department of Ophthalmology, Al Dhannah Hospital, Abu Dhabi, United Arab Emirates,Address for correspondence: Dr. Manish Jain, Department of Ophthalmology, Al Dhannah Hospital, Abu Dhabi, United Arab Emirates. E-mail:
| | - Sashwanthi Mohan
- Department of Vitreous and Retina, Rajan Eye Care Hospital, Chennai, Tamil Nadu, India
| | - Elon H. C. van Dijk
- Department of Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
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Dursun ME, Erdem S, Karahan M, Ava S, Hazar L, Dursun B, Keklikçi U. Evaluation of parafoveal vascular density using optical coherence tomography angiography in patients with central serous chorioretinopathy. Lasers Med Sci 2021; 37:1147-1154. [PMID: 34218316 DOI: 10.1007/s10103-021-03366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
Using optical coherence tomography angiography (OCTA), we sought to evaluate parafoveal vascular density (VD) in patients with central serous chorioretinopathy (CSCR). Our study included 43 patients with a diagnosis of CSCR and 40 healthy controls. Ophthalmologic examination findings and OCTA measurements of the participants were retrospectively analysed. Of the 43 patients with CSCR, 31 were males (72%) and 12 were females (28%); the control group was 30 males (75%) and 10 females (25%) (p = 0.657). There were significant differences between affected eyes, unaffected eyes and healthy control eyes for all parameters in the superficial capillary plexus (SCP) VD and deep capillary plexus (DCP) VD (p < 0.05 for all values). It was also determined that the affected eyes had lower SCP-VD and DCP-VD than the unaffected eyes and that the unaffected eyes had lower SCP-VD and DCP-VD than the healthy control eyes (p < 0.05 for all values). While there were no significant differences in the deep foveal avascular zone (FAZ) area, the superficial FAZ area was larger in affected eyes than in both unaffected eyes and healthy control eyes (p < 0.05). In most areas, the SCP-VD and DCP-VD values were lower and the FAZ larger in the chronic group than in the acute group (p < 0.05). Retinal vascular changes were found in patients with both acute and chronic CSCR, and the fellow eyes of these patients were also affected. OCTA can therefore be considered an easily applicable, non-invasive screening option for evaluating the microvascular structure in these patients.
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Affiliation(s)
- Mehmet Emin Dursun
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey.
| | - Seyfettin Erdem
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey
| | - Mine Karahan
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey
| | - Sedat Ava
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey
| | - Leyla Hazar
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey
| | - Birgül Dursun
- Department Ophthalmology, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey
| | - Uğur Keklikçi
- Department Ophthalmology, Medical Faculty, Dicle University, 21280, Diyarbakır, Turkey
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Hu YC, Chen YL, Chen YC, Chen SN. 3-year follow-up of half-dose verteporfin photodynamic therapy for central serous chorioretinopathy with OCT-angiography detected choroidal neovascularization. Sci Rep 2021; 11:13286. [PMID: 34168238 PMCID: PMC8225805 DOI: 10.1038/s41598-021-92693-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/14/2021] [Indexed: 11/09/2022] Open
Abstract
To assess the 3-year outcome of half-dose verteporfin photodynamic therapy (PDT) in central serous chorioretinopathy (CSC) with optical coherence tomography angiography (OCT-A) detected choroidal neovascularization (CNV), we performed a retrospective, interventional study. Patients were divided into 2 groups according to the fluorescein angiography: point source leakage in group 1 and diffuse oozing in group 2. Data were collected from patients including changes of best-corrected visual acuity (BCVA), size of CNV, central macular thickness (CMT), choroidal thickness (CT), reabsorption of subretinal fluid (SRF), sessions of half-dose PDT, and the number of intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF). There was a total of 34 eyes in 32 patients included. The mean sessions of half-dose PDT was 1.50 ± 0.75. The mean number of IVI of anti-VEGF was 1.38 ± 3.34. BCVA improved from 0.38 ± 0.33 to 0.20 ± 0.22 (p < 0.001). Mean CMT was significantly reduced along with reduced CT and increased size of CNV. SRF was totally reabsorbed in 31 eyes. Patients in group 1 had significant less sessions of PDT and better final BCVA. In conclusion, half-dose PDT treatment was effective for CSC with CNV. Patients with diffuse oozing in FA may fare less well with half-dose PDT.
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Affiliation(s)
- Yu-Chen Hu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Yi-Ling Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Yen-Chih Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, ROC.,Department of Ophthalmology, Changhua Christian Hospital Yunlin Branch, Yunlin, Taiwan, ROC.,Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
| | - San-Ni Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, ROC. .,School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC. .,Department of Optometry, Da-Yeh University, Changhua, Taiwan, ROC.
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Temporal Association between Topical Ophthalmic Corticosteroid and the Risk of Central Serous Chorioretinopathy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249455. [PMID: 33348672 PMCID: PMC7767174 DOI: 10.3390/ijerph17249455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 01/03/2023]
Abstract
This retrospective, nationwide, matched cohort study investigated the temporal relationship of central serous chorioretinopathy (CSCR) following topical ophthalmic corticosteroid (TOC) use. Using the Longitudinal Health Insurance Database 2000 (LHID2000), we collected patients diagnosed with CSCR between January 2001 and December 2010 (n = 2921) and a control group (n = 17,526). Information for each patient was collected and tracked from the index date until December 2011. TOC users were classified based on (i) the date of the last prescription before diagnosis: current users (≤30 days) and former users (31–182 days and ≥183 days) and (ii) the prescription refill intervals: persistent users (interval ≤90 days) and non-persistent users (interval >90 days). The odds ratio (OR) was estimated from multivariate conditional logistic regression after adjusting for relevant confounders. After adjusting for age, sex, geographic region, index date, previously known comorbidities, the date of last TOC prescription before diagnosis, or prescription refilling intervals, the results revealed that patients were likely to have developed CSCR while using TOCs currently (OR = 30.42, 95% CI = 25.95–35.66, p < 0.001) and persistently (OR = 7.30, 95% CI = 6.13–8.69, p < 0.001) as compared to the controls. Our results indicate that current or persistent TOCs use increases the risk of CSCR. Thus, patients requiring TOCs should be advised of this risk, particularly in current or persistent use conditions.
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Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance. J Ophthalmol 2020; 2020:1712503. [PMID: 32104592 PMCID: PMC7038385 DOI: 10.1155/2020/1712503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/06/2020] [Accepted: 01/18/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose Patients with central serous chorioretinopathy (CSC) typically present with acute visual impairment and metamorphopsia. The disease previously has been associated with psychological stress. Population-based cohort studies on the risk of CSC among patients with nonorganic sleep disturbance (NOSD) are limited. An early sign of psychiatric disorder was probably sleep disturbance. Furthermore, psychological stress may be caused by sleep disturbance. We investigated the relationship between NOSD and the incidence of CSC. Design Longitudinal cohort study. Participants. We used the Longitudinal Health Insurance Database and collected the data of 53,743 NOSD patients without CSC between 2000 and 2005 as the study group. Four-fold controls were selected randomly from those without neither sleep disturbance nor a CSC history with frequency matching of age, sex, and index-year. Methods The difference in sex, age group, comorbidities, and steroid use between the two groups was analyzed by the χ 2 test. Cox-proportional hazard regression was utilized to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for comparison of the two groups. Kaplan-Meier analysis was applied to measure the cumulative incidence of CSC. Furthermore, the log-rank test was used to test the incidence difference between the two groups. Main Outcome Measures. The incidence rate of CSC in the following years until 2011 was detected. Results During a mean follow-up of 7.36 ± 2.88 years, NOSD patients had a higher incidence of CSC than the controls (3.10 vs. 1.86 per 10,000 person-years; adjusted HR, 1.65; 95% CI, 1.34-2.02). Men had a higher risk of CSC than women. Sensitivity analyses stratified by sex, age group, or comorbidity condition showed consistently that NOSD patients had a higher risk of CSC than their controls. Dose-response showed that higher NOSD severity had even higher CSC risk. Conclusions NOSD is an independent indicator for the increased risk of subsequent CSC development.
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Huang KH, Chen YH, Lee LC, Tai MC, Chung CH, Chen JT, Liang CM, Chien WC, Chen CL. Relationship between heart failure and central serous chorioretinopathy: A cohort study in Taiwan. J Chin Med Assoc 2019; 82:941-947. [PMID: 31805017 DOI: 10.1097/jcma.0000000000000207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Both central serous chorioretinopathy (CSCR) and heart failure (HF) are disorders with a complex pathogenesis, whereas the two diseases might share similar pathogenesis. This study aimed to evaluate whether patients with HF are exposed to potential risk of CSCR by using the National Health Insurance Research Database (NHIRD). METHODS Data were collected from the NHIRD over a 14-year period. Variables were analyzed with the Pearson chi-square test and Fisher's exact test. The risk factors for disease development were examined by adjusted hazard ratio (aHR). Kaplan-Meier analysis was performed to compare the cumulative incidence of CSCR. RESULTS A total of 24 426 patients with HF were enrolled in the study cohort, and there were 24 426 patients without HF in the control cohort. The incidence rate of CSCR was higher in the study cohort than in the control cohort (aHR = 4.572, p < 0.001). CSCR occurred more commonly in males than in females. The overall incidence of CSCR was 30.07 per 100 000 person-years in the study cohort and 23.06 per 100 000 person-years in the control cohort. Besides, subgroup analysis revealed that no matter in gender or age group, HF patients were in an increased risk of CSCR diagnosis (male/female, aHR = 3.268/7.701; 20-59 years/≥60 years, aHR = 3.405/5.501, p < 0.001). CONCLUSION HF is a significant indicator for CSCR. Patients with HF should stay alert for potential disorder of visual impairment. Further prospective studies to investigate the relationship between HF and CSCR could provide more information.
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Affiliation(s)
- Ke-Hao Huang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- Department of Ophthalmology, Song-Shan Branch of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Lung-Chi Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chang-Min Liang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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Chang YS, Weng SF, Wang JJ, Jan RL. Increased risk of central serous chorioretinopathy following end-stage renal disease: A nationwide population-based study. Medicine (Baltimore) 2019; 98:e14859. [PMID: 30882685 PMCID: PMC6426587 DOI: 10.1097/md.0000000000014859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
This retrospective, nationwide, matched cohort study investigated the risk of central serous chorioretinopathy (CSCR) following end-stage renal disease (ESRD). The study cohort included 84722 ESRD patients who were registered between January 2000 and December 2009 at the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 84722 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. We collected information for each patient from the index date until December 2011. During the follow-up period, we found a significantly elevated risk of CSCR in the ESRD patients compared with controls (incidence rate ratio = 1.51, 95% confidence interval = 1.24-1.84). After adjustment for potential confounders, including age, sex, coronary artery disease, peptic ulcer, and obstructive sleep apnea, ESRD patients were 1.41 times more likely to develop CSCR (adjusted hazard ratio = 1.41, 95% confidence interval = 1.14-1.73). In conclusion, we found that ESRD patients showed a significantly higher risk of developing CSCR and recommend regular retina examinations and education regarding CSCR for patients with ESRD.
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Affiliation(s)
- Yuh-Shin Chang
- Department of Ophthalmology, Chi Mei Medical Center
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung
| | - Jhi-Joung Wang
- Department of Medical Research
- Department of Anesthesiology
| | - Ren-Long Jan
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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Ersoz MG, Arf S, Hocaoglu M, Sayman Muslubas I, Karacorlu M. Patient characteristics and risk factors for central serous chorioretinopathy: an analysis of 811 patients. Br J Ophthalmol 2018; 103:725-729. [DOI: 10.1136/bjophthalmol-2018-312431] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/04/2018] [Accepted: 06/15/2018] [Indexed: 11/04/2022]
Abstract
AimsTo determine the demographic and morphological characteristics of patients with central serous chorioretinopathy (CSC) and describe risk factors for CSC.MethodsWe retrospectively reviewed medical records of 811 patients with CSC and 816 healthy controls referred from 2002 to 2018.ResultsThe female/male ratio of patients with CSC was 1/2.7. Mean age of onset was 45.2 years. The peak prevalence for men occurred at 45–49 years. Women had two prevalence peaks, the higher at 55–59 years and the other at 45–49 years. Of these patients, 56.8% had unilateral disease, 42.1% had bilateral disease and 1.1% had only one eye. 671 (82.7%) patients had spectral domain optical coherence tomography (SD-OCT) images and 598 (73.7%) had enhanced depth choroidal images. Pigment epithelial detachment (PED) was detected in 763 (80.7%) of 945 eyes with SD-OCT images. Chronic cases were more likely to be bilateral and multifocal and to have PED (all p<0.001). Subfoveal choroidal thickness (SFCT) did not differ between chronic and classic cases (p=0.74), but SFCT was greater in multifocal cases than unifocal cases (p<0.001). In multivariate regression analyses, older age of onset, longer duration of disease and hyperopia were positively associated with having chronic disease rather than classic disease, and myopia and thyroid hormone replacement were negatively associated. Steroid use, antidepressant or anxiolytic drug use, smoking, pregnancy and hyperopia were risk factors, and myopia was a protective factor for CSC.ConclusionThis is the largest case-control study of CSC to evaluate demographic morphological characteristics and risk factors. Multiple factors are associated with CSC.
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Chatziralli I, Kabanarou SA, Parikakis E, Chatzirallis A, Xirou T, Mitropoulos P. Risk Factors for Central Serous Chorioretinopathy: Multivariate Approach in a Case-Control Study. Curr Eye Res 2017; 42:1069-1073. [PMID: 28306346 DOI: 10.1080/02713683.2016.1276196] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The purpose of this prospective study was to investigate the potential risk factors associated independently with central serous retinopathy (CSR) in a Greek population, using multivariate approach. MATERIALS AND METHODS Participants in the study were 183 consecutive patients diagnosed with CSR and 183 controls, matched for age. All participants underwent complete ophthalmological examination and information regarding their sociodemographic, clinical, medical and ophthalmological history were recorded, so as to assess potential risk factors for CSR. Univariate and multivariate analysis was performed. RESULTS Univariate analysis showed that male sex, high educational status, high income, alcohol consumption, smoking, hypertension, coronary heart disease, obstructive sleep apnea, autoimmune disorders, H. pylori infection, type A personality and stress, steroid use, pregnancy and hyperopia were associated with CSR, while myopia was found to protect from CSR. In multivariate analysis, alcohol consumption, hypertension, coronary heart disease and autoimmune disorders lost their significance, while the remaining factors were all independently associated with CSR. CONCLUSIONS It is important to take into account the various risk factors for CSR, so as to define vulnerable groups and to shed light into the pathogenesis of the disease.
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Affiliation(s)
- Irini Chatziralli
- a 2nd Department of Ophthalmology , Ophthalmiatrion Athinon , Athens , Greece
| | - Stamatina A Kabanarou
- b Medical Retina Department , Korgialeneio Benakeio, Red Cross Hospital , Athens , Greece
| | | | | | - Tina Xirou
- b Medical Retina Department , Korgialeneio Benakeio, Red Cross Hospital , Athens , Greece
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Abstract
PURPOSE Central serous chorioretinopathy (CSC) is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains ambiguous. The systematic review and meta-analysis aimed to measure risk factors for CSC in a quantitative method, providing some precautions and interventions on this disease and preventing further recurrences. METHODS A comprehensive literature review relating to risk factors for CSC through PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and VIP databases was conducted before March 2015. Odds ratio (OR) with 95% confidence interval (CI) was calculated after data combination to assess the associations between risk factors and CSC. RESULTS A total of 9839 patients in 17 studies were included and risk factors with significant differences found between CSC and control groups were listed as follows: hypertension (OR = 1.7; 95% CI: 1.28-2.25), Helicobacter pylori (H. pylori) infection (OR = 3.12; 95% CI: 1.81-5.40), steroid usage (OR = 4.29; 95% CI: 2.01-9.15), sleeping disturbance (OR = 1.90; 95% CI: 1.28-1.83), autoimmune disease (OR=3.44; 95% CI: 1.90-6.26), psychopharmacologic medication use (OR = 2.69; 95% CI: 1.63-4.45), and Type-A behavior (OR = 2.53; 95% CI: 1.08-5.96). CONCLUSION The authors concluded that hypertension, H. pylori infection, steroid usage, sleeping disturbance, autoimmune disease, psychopharmacologic medication use, and Type-A behavior were possible risk factors relating to the occurrence of CSC.
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Shift Work: A Risk Factor for Central Serous Chorioretinopathy. Am J Ophthalmol 2016; 165:23-8. [PMID: 26915576 DOI: 10.1016/j.ajo.2016.02.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 01/18/2016] [Accepted: 02/15/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate if shift work or sleep disturbances are risk factors for central serous chorioretinopathy (CSCR). DESIGN Prospective case-control study. METHODS Forty patients with active CSCR and 40 controls (age- and sex-matched) were prospectively recruited from the Ophthalmology Department of Hôtel Dieu Hospital, Paris, between November 2013 and December 2014. All patients were asked to complete a questionnaire addressing previously described risk factors and working hours, as well as the Insomnia Severity Index (ISI), a validated instrument for assessing sleep disturbances. RESULTS The mean age of the CSCR group was 44 ± 9 years, whereas the mean age of the control group was 43 ± 10 years. By use of multivariate analysis, shift work (odds ratio [OR] [95% confidence interval]: 5 [1.2-20.4]; P = .02), steroid use (OR: 5.5 [1.1-26.2]; P = .03), and recent psychological stress (OR: 15.3 [4.1-54.5]; P < .001) were found to be independently associated with CSCR. CONCLUSION The outcomes of this study suggest that shift work is an independent risk factor of CSCR. Further studies are required to confirm these results and to examine if work reconversion would be beneficial in the treatment of patients with chronic/recurrent CSCR.
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Age-Related Macular Degeneration and Risk of Degenerative Dementia among the Elderly in Taiwan. Ophthalmology 2015; 122:2327-2335.e2. [DOI: 10.1016/j.ophtha.2015.07.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 07/20/2015] [Accepted: 07/29/2015] [Indexed: 12/26/2022] Open
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