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Karimi S, Payandeh N, Mahmoudi Nejad Azar S, Nouri H, Abtahi S-H. Central Serous Chorioretinopathy Risk Factors in An Iranian Cohort: A Case-control Study. JOVR [Internet]. 2023Nov.30 [cited 2024May14];18(4):410–416. Available from: https://knepublishing.com/index.php/JOVR/article/view/14553
https://doi.org/10.18502/jovr.v18i4.14553
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authors
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Saeed Karimi
Saeed Karimi
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nastaran Payandeh
Nastaran Payandeh
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sahar Mahmoudi Nejad Azar
Sahar Mahmoudi Nejad Azar
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hosein Nouri
Hosein Nouri
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Seyed-Hossein Abtahi
Seyed-Hossein Abtahi
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Nov 30, 2023
Central Serous Chorioretinopathy Risk Factors in An Iranian Cohort: A Case-control Study
Abstract
Purpose: This study aimed to investigate the possible risk factors of central serous chorioretinopathy (CSCR) in an Iranian cohort.
Methods: We recruited 39 consecutive CSCR cases and 80 age-matched controls with no ocular pathology from the same medical center from March 2019 to March 2021. Enrolled patients underwent complete ophthalmological examination and extensive history taking in a referral setting. Logistic regression analysis was performed to detect any possible association of potential risk factors with CSCR.
Results: The mean age of CSCR patients was 40.69±7.71 years. The male-to-female ratio in cases and controls was 1:1.79 and 1.22:1, respectively. Logistic regression analysis revealed that alcohol consumption (odds ratio, OR: 62.0, P <0.001), smoking (OR: 4.0, 95% CI: 1.47-10.85, P <0.006), corticosteroid use (OR: 6.95, 95% CI: 2.64-18.28, P <0.001), and high psychological stress (OR: 13.34, 95% CI: 4.68-38.02, P <0.01) were significant risk factors for developing CSCR. Ischemic heart disease (P =0.550), hypertension (P =0.750), and hyperopia (P =0.467) were not associated with the risk of CSCR. The most common form of steroid use was oral in both groups. No pregnant female was present in the study sample, precluding the assessment of its potential association with CSCR.
Conclusion: CSCR often affects individuals of productive working ages; thus, identifying its preventable risk factors is highly encouraged. Our results suggested that alcohol consumption, smoking, and high levels of psychological stress are independent, preventable risk factors for CSCR.
Keywords:
Central Serous Chorioretinopathy, Risk Factors, Smoking, Alcohol Drinking, Psychological Stress
References
1. Kaye R, Chandra S, Sheth J, Boon CJ, Sivaprasad S, Lotery A. Central serous chorioretinopathy: an update on risk factors, pathophysiology and imaging modalities. Prog Retin Eye Res. 2020;79:100865.
2. Kumawat D, Ravi AK, Sahay P, Alam T, Desai A, Kumar A. Systemic evaluation of patients with central serous chorioretinopathy: A case-control study. Eur J Ophthalmol. 2021;31:3223–3230.
3. Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015;48:82–118.
4. Liu B, Deng T, Zhang J. Risk factors for central serous chorioretinopathy: A Systematic review and meta-analysis. Vol. 36, Retina. Retina. 2016;36:9–19.
5. 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;42:1069–73.
6. Imamura Y, Fujiwara T, Spaide RF. Frequency of glaucoma in central serous chorioretinopathy: a case-control study. Retina. 2010;30:267–270.
7. Park HL. Environmental Toxicants, Epigenetics, and Cancer. Mol Integr Toxicol; 2015. pp. 131–154.
8. Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol. 2013;58:103–126.
9. Yavaş GF, Küsbeci T, Kaşikci M, Günay E, Dogan M, Ünlü M, et al. Obstructive Sleep Apnea in Patients with Central Serous Chorioretinopathy. Current Eye Research. 2013;39:88–92.
10. Roshani M, Davoodi NA, Seyyedmajidi MR, Zojaji H, Sherafat SJ, Hashemi M, et al. Association of Helicobacter pylori with central serous chorioretinopathy in Iranian patients. Gastroenterol Hepatol Bed Bench. 2014;7:63–67.
11. 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. 2019;103:725–729.
12. Yu J, Xu G, Chang Q, Ye X, Li L, Jiang C, Zhao Q. Risk factors for persistent or recurrent central serous chorioretinopathy. J Ophthalmol. 2019;2019.
13. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress [Internet]. J Health Soc Behav. 1983;24:385–396. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6668417
14. Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP. The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980-2002. Ophthalmology. 2008;115:169–173.
15. Karimi S, Nouri H, Mahmoudinejad-Azar S, Abtahi SH. Smoking and environmental tobacco smoke exposure: implications in ocular disorders [Internet]. Cutan Ocul Toxicol. 2023;42:1–7. Available from: https://www.tandfonline.com/doi/full/10.1080/15569527. 2022.2144874
16. Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, et al. Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina. 1996;16:203–213.
17. Toyama T, Ohtomo K, Noda Y, Ueta T. Polypoidal choroidal vasculopathy and history of central serous chorioretinopathy. Eye (Lond). 2014;28:992–997.
18. Haimovici R, Koh S, Gagnon DR, Lehrfeld T, Wellik S; Central Serous Chorioretinopathy Case-Control Study Group. Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004;111:244–249.
19. Suñer IJ, Espinosa-Heidmann DG, Marin-Castano ME, Hernandez EP, Pereira-Simon S, Cousins SW. Nicotine increases size and severity of experimental choroidal neovascularization. Invest Ophthalmol Vis Sci. 2004;45:311–317.
20. Ciulla TA, Harris A, Kagemann L, Danis RP, Pratt LM, Chung HS, et al. Choroidal perfusion perturbations in non-neovascular age related macular degeneration. Br J Ophthalmol. 2002;86(2):209–213.
21. Kang HM, Woo YJ, Koh HJ, Lee CS, Lee SC. The effect of consumption of ethanol on subfoveal choroidal thickness in acute phase. Br J Ophthalmol. 2016;100:383–388.
22. Tittl MK, Spaide RF, Wong D, Pilotto E, Yannuzzi LA, Fisher YL, et al. Systemic findings associated with central serous chorioretinopathy. Am J Ophthalmol. 1999;128:63–68.
23. Chen SN, Chen YC, Lian I. Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study. Br J Ophthalmol. 2014 Jan;98(1):110–114.
24. Terao N, Koizumi H, Kojima K, Kusada N, Nagata K, Yamagishi T, et al. Short axial length and hyperopic refractive error are risk factors of central serous chorioretinopathy. Br J Ophthalmol. 2020;104:1260– 1265.
25. Chang YS, Weng SF, Wang JJ, Jan RL. Temporal Association between Topical Ophthalmic Corticosteroid and the Risk of Central Serous Chorioretinopathy. Int J Environ Res Public Health. 2020;17:1–11.
26. Chang YS, Weng SF, Chang C, Wang JJ, Wang JY, Jan RL. Associations Between Topical Ophthalmic Corticosteroids and Central Serous Chorioretinopathy: A Taiwanese Population-Based Study. Invest Ophthalmol Vis Sci. 2015;56:4083–4089.
27. Tsai DC, Chen SJ, Huang CC, Chou P, Chung CM, Chan WL, et al. Risk of central serous chorioretinopathy in adults prescribed oral corticosteroids: a population-based study in Taiwan. Retina. 2014;34:1867–1874.
28. Yannuzzi LA. Type A behavior and central serous chorioretinopathy [Internet]. Trans Am Ophthalmol Soc. 1986;84:799–845. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3590481
29. Genovese G, Meduri A, Muscatello MR, Gangemi S, Cedro C, Bruno A, et al. Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020) [Internet]. Medicina (Kaunas). 2021 Jun;57(6):628. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34208694
30. Lahousen T, Painold A, Luxenberger W, Schienle A, Kapfhammer HP, Ille R. Psychological factors associated with acute and chronic central serous chorioretinopathy. 2015;70:24–30.
31. Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41:201– 214.
32. Yu J, Li L, Jiang C, Chang Q, Xu G. Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population. J Ophthalmol. 2021.
33. Carvalho-Recchia CA, Yannuzzi LA, Negrão S, Spaide RF, Freund KB, Rodriguez-Coleman H, et al. Corticosteroids and central serous chorioretinopathy. Ophthalmology. 2002;109:1834–1837.
2. Kumawat D, Ravi AK, Sahay P, Alam T, Desai A, Kumar A. Systemic evaluation of patients with central serous chorioretinopathy: A case-control study. Eur J Ophthalmol. 2021;31:3223–3230.
3. Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015;48:82–118.
4. Liu B, Deng T, Zhang J. Risk factors for central serous chorioretinopathy: A Systematic review and meta-analysis. Vol. 36, Retina. Retina. 2016;36:9–19.
5. 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;42:1069–73.
6. Imamura Y, Fujiwara T, Spaide RF. Frequency of glaucoma in central serous chorioretinopathy: a case-control study. Retina. 2010;30:267–270.
7. Park HL. Environmental Toxicants, Epigenetics, and Cancer. Mol Integr Toxicol; 2015. pp. 131–154.
8. Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol. 2013;58:103–126.
9. Yavaş GF, Küsbeci T, Kaşikci M, Günay E, Dogan M, Ünlü M, et al. Obstructive Sleep Apnea in Patients with Central Serous Chorioretinopathy. Current Eye Research. 2013;39:88–92.
10. Roshani M, Davoodi NA, Seyyedmajidi MR, Zojaji H, Sherafat SJ, Hashemi M, et al. Association of Helicobacter pylori with central serous chorioretinopathy in Iranian patients. Gastroenterol Hepatol Bed Bench. 2014;7:63–67.
11. 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. 2019;103:725–729.
12. Yu J, Xu G, Chang Q, Ye X, Li L, Jiang C, Zhao Q. Risk factors for persistent or recurrent central serous chorioretinopathy. J Ophthalmol. 2019;2019.
13. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress [Internet]. J Health Soc Behav. 1983;24:385–396. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6668417
14. Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP. The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980-2002. Ophthalmology. 2008;115:169–173.
15. Karimi S, Nouri H, Mahmoudinejad-Azar S, Abtahi SH. Smoking and environmental tobacco smoke exposure: implications in ocular disorders [Internet]. Cutan Ocul Toxicol. 2023;42:1–7. Available from: https://www.tandfonline.com/doi/full/10.1080/15569527. 2022.2144874
16. Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, et al. Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina. 1996;16:203–213.
17. Toyama T, Ohtomo K, Noda Y, Ueta T. Polypoidal choroidal vasculopathy and history of central serous chorioretinopathy. Eye (Lond). 2014;28:992–997.
18. Haimovici R, Koh S, Gagnon DR, Lehrfeld T, Wellik S; Central Serous Chorioretinopathy Case-Control Study Group. Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004;111:244–249.
19. Suñer IJ, Espinosa-Heidmann DG, Marin-Castano ME, Hernandez EP, Pereira-Simon S, Cousins SW. Nicotine increases size and severity of experimental choroidal neovascularization. Invest Ophthalmol Vis Sci. 2004;45:311–317.
20. Ciulla TA, Harris A, Kagemann L, Danis RP, Pratt LM, Chung HS, et al. Choroidal perfusion perturbations in non-neovascular age related macular degeneration. Br J Ophthalmol. 2002;86(2):209–213.
21. Kang HM, Woo YJ, Koh HJ, Lee CS, Lee SC. The effect of consumption of ethanol on subfoveal choroidal thickness in acute phase. Br J Ophthalmol. 2016;100:383–388.
22. Tittl MK, Spaide RF, Wong D, Pilotto E, Yannuzzi LA, Fisher YL, et al. Systemic findings associated with central serous chorioretinopathy. Am J Ophthalmol. 1999;128:63–68.
23. Chen SN, Chen YC, Lian I. Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study. Br J Ophthalmol. 2014 Jan;98(1):110–114.
24. Terao N, Koizumi H, Kojima K, Kusada N, Nagata K, Yamagishi T, et al. Short axial length and hyperopic refractive error are risk factors of central serous chorioretinopathy. Br J Ophthalmol. 2020;104:1260– 1265.
25. Chang YS, Weng SF, Wang JJ, Jan RL. Temporal Association between Topical Ophthalmic Corticosteroid and the Risk of Central Serous Chorioretinopathy. Int J Environ Res Public Health. 2020;17:1–11.
26. Chang YS, Weng SF, Chang C, Wang JJ, Wang JY, Jan RL. Associations Between Topical Ophthalmic Corticosteroids and Central Serous Chorioretinopathy: A Taiwanese Population-Based Study. Invest Ophthalmol Vis Sci. 2015;56:4083–4089.
27. Tsai DC, Chen SJ, Huang CC, Chou P, Chung CM, Chan WL, et al. Risk of central serous chorioretinopathy in adults prescribed oral corticosteroids: a population-based study in Taiwan. Retina. 2014;34:1867–1874.
28. Yannuzzi LA. Type A behavior and central serous chorioretinopathy [Internet]. Trans Am Ophthalmol Soc. 1986;84:799–845. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3590481
29. Genovese G, Meduri A, Muscatello MR, Gangemi S, Cedro C, Bruno A, et al. Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020) [Internet]. Medicina (Kaunas). 2021 Jun;57(6):628. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34208694
30. Lahousen T, Painold A, Luxenberger W, Schienle A, Kapfhammer HP, Ille R. Psychological factors associated with acute and chronic central serous chorioretinopathy. 2015;70:24–30.
31. Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41:201– 214.
32. Yu J, Li L, Jiang C, Chang Q, Xu G. Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population. J Ophthalmol. 2021.
33. Carvalho-Recchia CA, Yannuzzi LA, Negrão S, Spaide RF, Freund KB, Rodriguez-Coleman H, et al. Corticosteroids and central serous chorioretinopathy. Ophthalmology. 2002;109:1834–1837.