June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Psychological Stress during COVID-19 and Central Serous Chorioretinopathy (CSCR)
Author Affiliations & Notes
  • Mathilde Franklin
    Ophthalmology, Wagner and Kapoor Research Institute, Virginia Beach, Virginia, United States
    Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, United States
  • Alan Wagner
    Ophthalmology, Wagner and Kapoor Research Institute, Virginia Beach, Virginia, United States
    Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, United States
  • Kapil Kapoor
    Ophthalmology, Wagner and Kapoor Research Institute, Virginia Beach, Virginia, United States
    Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, United States
  • Footnotes
    Commercial Relationships   Mathilde Franklin, None; Alan Wagner, None; Kapil Kapoor, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1971. doi:
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      Mathilde Franklin, Alan Wagner, Kapil Kapoor; Psychological Stress during COVID-19 and Central Serous Chorioretinopathy (CSCR). Invest. Ophthalmol. Vis. Sci. 2021;62(8):1971.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Psychological stress is a well-documented risk factor for developing CSCR. Given the unprecedented nature of COVID-19, we wanted to analyze the relationship between the pandemic and CSCR cases in a retrospective, cross-sectional study.

Methods : All newly diagnosed CSCR cases were identified from nine clinics across Hampton Roads, VA (2015—2020). The medical billing system was used to query all CSCR cases, and other causes for retinal exudation were excluded, including inflammation, infiltration, hemorrhage, and choroidal neovascularization. Demographic data and previously reported risk factors were recorded, including recent stressors. CSCR cases and risk factors were compared between the pre-pandemic timeframe (Jan 2015—Feb 2020) and the COVID period (Mar 2020—Sept 2020). Cases were also compared using three-month rolling sums. Categorical variables were analyzed using Chi-square analysis and Fisher’s exact test. Continuous variables were analyzed using the Student’s t-test.

Results : A total of 247 patients with CSCR were identified with 205 patients in the pre-COVID-19 period and 42 during COVID-19. The total number of CSCR cases per month was analyzed over 69 months (Fig 1). There was an average of 3.61 CSCR cases per month (SD, 2.21; range, 0—10 cases; median, 3 cases). The highest number of cases occurred in May 2020 (10 cases, 99.3 percentile). When comparing the CSCR cases longitudinally (Fig 2), the highest number of cases occurred in 2020 with an average of 6.7 monthly cases. The year 2020 was significantly different from 2015, 2016, 2017, and 2018 (P < 0.001). When analyzing the cases using three-month rolling sums, May—July 2020 had the largest number of cases (22 cases, 99.25 percentile), and January—March 2020 had the second-highest total (21 cases, 97.8 percentile). Recent psychological stress was present in 19% of the COVID-era and only 9% of the pre-COVID patients, but was not significantly significant (P = 0.065).

Conclusions : The relationship between a worldwide pandemic in the development of CSCR has not been previously reported. While the largest number of monthly cases occurred during the pandemic, there was a relative increase shortly before the designated pandemic start-date. Larger, retrospective studies are warranted to evaluate the significance of these findings.

This is a 2021 ARVO Annual Meeting abstract.

 

Scatter plot and trend line of total CSCR cases per month over time.

Scatter plot and trend line of total CSCR cases per month over time.

 

Box-and-whisker plot of monthly CSCR cases for each year.

Box-and-whisker plot of monthly CSCR cases for each year.

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