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David Warrow, Krishna Mukkamala, Richard B. Rosen; Relationship between Helicobacter Pylori and Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5227.
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To determine the prevalence of gastrointestinal helicobacter pylori (HP) infection in patients with central serous chorioretinopathy (CSR).
Between January 2010 and September 2011, 17 patients were evaluated for CSR and recruited into this IRB approved, prospective study at the New York Eye and Ear Infirmary Retina Center. CSR diagnosis was made via (i) comprehensive ophthalmic examination, (ii) fluorescein angiography, (iii) optical coherence tomography (OCT), and (iv) fundus photography. CSR risk factor assessment questionairres were administered. Helicobacter pylori testing was then performed via the 13C-urea breath test.
Of the 17 CSR patients, 14 were male (82.4%) and 3 were female (17.6%). The mean age was 46.2 +/- 12.8 years. 3 subjects (17.6%) tested positive for HP infection. Of the 14 patients who tested negative, 4 of these subjects underwent urea breath testing when their CSR was quiescent. Of note regarding CSR risk factors, 4 subjects (23.5%) had recent corticosteroid use, 4 subjects (23.5%) were smokers, 3 subjects (17.6%) had systemic hypertension, 5 subjects (29.4%) reported obstructive sleep apnea symptoms, and 10 subjects (58.8%) reported significant stress and anxiety.
This prospective study identifies a much lower prevalence of HP infection in patients with CSR than previous, predominantly retrospective studies (44-78% prevalence range), indicate. This disparity may stem from the fact that HP testing in this study was performed during periods of CSR quiescence in 4 of the negative subjects. The first case report (Giusti, 2001) that examined the relationship between HP and CSR observed HP positivity only during CSR recurrences, while HP was negative during CSR quiescience following successful anti-HP triple therapy. Additional prospective evaluation is necessary to further explore the etiology of CSR and the potential role of helicobacter pylori.
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