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Maggie Zhou, Sophie Bakri, Suzann Pershing; Risk Factors for Central Serous Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1036.
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© ARVO (1962-2015); The Authors (2016-present)
Central serous retinopathy (CSR) is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy, and retinal vein occlusions. To date most research on disease risk factors has been limited to smaller case-control studies and epidemiologic studies.
We conducted a retrospective analysis using the Truven Health MarketScan® Commercial and Medicare Supplemental Databases from January 1, 2007, to December 31, 2015. We limited the study cohort to patients continuously enrolled for at least 36 months. CSR and other clinical co-morbidities were identified by International Classification of Diseases, Ninth Revision (ICD-9) codes. Cases of prevalent CSR were excluded based on a 1-year lookback period to identify beneficiaries with a CSR diagnosis in 2007 or the first year of their enrollment in the health plan.
A total of 46,148 individuals were identified with incident CSR between 2007 and 2015. Multivariable regression analysis demonstrated that a CSR diagnosis was more likely with male gender (OR 3.39; 95% CI 3.30-3.47), age 35-44 years (OR 19.18; 95% CI 16.48-22.32) relative to age 0-17 years, northeast region (OR 1.42; 95% CI 1.38-1.46) relative to south region, individual enrollment in a health plan (OR 1.45; 95% CI 1.42-1.48) relative to employer-sponsored coverage, and steroid use in the past year (OR 469.9; 95% CI 433.1-509.8). Diagnosis of CSR was less likely among beneficiaries with a history of glaucoma (OR 0.18; 95% CI 0.17-0.18), essential hypertension (OR 0.07; 95% CI 0.07-0.07), diabetes mellitus and diabetic eye disorders (OR 0.20; 95% CI 0.19-0.21), sleep disorder (OR 0.11; 95% CI 0.10-0.12), or gastroesophageal reflux disease (OR 0.08; 95% CI 0.08-0.08).
In a large national population-based analysis, our results reinforce the association of male sex, steroid use, and middle age with a CSR diagnosis, especially ages 35-44 years old, and demonstrate that CSR is rare among individuals 0-17 years of age. We also find lower odds of CSR among beneficiaries with a history of glaucoma, essential hypertension, diabetes mellitus, sleep disorder, or gastroesophageal reflux disease, which may represent confounders including interactions with the health care system and type of provider (optometrist vs. ophthalmologist vs. subspecialist). More research is needed to examine the etiology of these associations.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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