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Yunfei Yang, Sarah Ruth Stevenson, Colm Andrews, Iona Alexander, Russell Foster, Susan Downes; Effect of Central Serous Chorioretinopathy on Sleep and Mood. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5165.
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Ocular disorders, through circadian disruption, have been reported to have an adverse impact on sleep and mood, resulting in metabolic, inflammatory and neoplastic disease. Central serous retinopathy (CSR) is associated with high steroid use, type A personality and shift work; factors also known to disturb sleep. We performed a cross-sectional, questionnaire-based study to evaluate sleep quality and mood in patients with CSR.
76 participants with CSR aged 30-83 years were recruited from Ophthalmology clinics in Oxford, UK. These were compared to 236 control participants aged 18–85 years recruited from 5 UK sites.All participants were recruited between 2012 and 2017 as part of the SOMNUS (“Effect of Ocular Disease on Sleep and Circadian Rhythms”) Portfolio Study. Exclusion criteria included treatment with benzodiazepines, diagnosis of organic physical or psychiatric conditions or pregnancy. Use of anti-anxiety/anti-depressants was noted separately.Primary outcome measures included subjective sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI) (PSQI >5 being considered poor sleep). Secondary outcomes included anxiety and depression scores, determined by the Hospital Anxiety and Depression Scale (HADS), ( >7 considered mild) and best visual acuity compared against PSQI.Data was analysed using a multilinear model (www.R-project.org), controlling for age and sex, with significance level p > 0.05.
The mean age of CSR participants was 53.36±11.26 years (65.79% male) compared to 49.72±15.43 years (27.54% male) in controls. Of CSR participants, 29% were affected in the left, 19% in the right eye and 28% both eyes. 41% of CSR participants had a history of steroid use (including either guttae, oral, topical or other). When controlled for sex and age, we found:- Mean PSQI was significantly higher in CSR 5.28±3.15 SD than in controls 4.76±3.01 SD (p=0.0026).- 42.11% of CSR had PSQI > 5 compared to 32.64% controls- No significant relationship was found between visual acuity and PSQI (p > 0.05)- Mean HADS depression subscore was similar in CSR (mean 2.54±2.46 SD) and controls (2.4±2.25 SD) (p > 0.05)- There was no difference in mean HADS anxiety subscore in CSR (5.28±3.21SD) compared to controls (5.48±3.15SD) (p > 0.05).
Sleep, but not mood, disturbance is more prevaleant in CSR and should be considered in the assessment of patients with CSR as they may benefit from sleep interventions.
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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