Central serous chorioretinopathy and risk of ischaemic stroke: a population-based cohort study

Tsai, Der‐Chong; Huang, Chin Chou; Chen, Shih‐Jen; Chou, Pesus; Chung, Chia Min; Chan, Wan Leong; Huang, Po Hsun; Chen, Tseng Ji; Lin, Shing Jong; Chen, Jaw Wen; Leu, Hsin Bang

doi:10.1136/bjophthalmol-2012-301810

Cited by 38 publications

(26 citation statements)

References 35 publications

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“…Haimovici et al 13 reported that uncontrolled systemic hypertension, instead of hypertension, is a risk factor for CSCR. An increased incidence of stroke has been reported in patients with CSCR by Tsai et al 14 In their study, after adjusting for other confounding factors, CSCR is reported to be an independent risk factor for stroke. Tittl et al 11 studied the correlation between CHD and CSCR, in which logistic regression analysis results revealed that CHD is not a statistically significant risk factor for CSCR.…”

Section: Discussionmentioning

confidence: 61%

Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study

Chen

Lian

2013

Br J Ophthalmol

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AimsTo investigate whether patients with central serous chorioretinopathy (CSCR) have increased risk of coronary heart disease (CHD). Methods Population-based retrospective cohort and case control study. Longitudinal data from the Taiwan National Health Insurance Research Database (2000Database ( -2009 were analysed. The study cohort comprised 835 patients with a diagnosis of CSCR and 4175 age and gender matched patients without CSCR. Kaplan-Meier plots and log-rank tests were used to compare differences in the hazard rates of CHD between the CSCR and non-CSCR cohorts. Stratified Cox proportional hazard models were applied to examine the association between CSCR and CHD, adjusting for potential confounding factors. Results The 5-year CHD cumulative incidence for patients with CSCR was nearly twofold that of the non-CSCR cohort (6.12% vs 3.29%, p=0.004) from the logrank test. The adjusted CHD HR of CSCR versus non-CSCR was 1.61 (95% CI 1.12 to 2.30, p=0.009) from the Cox model. Specifically, the HR for male patients was 1.72 (95% CI 1.14 to 2.59, p=0.010) and for female patients it was 1.34 (95% CI 0.64 to 2.84, p=0.438). Conclusions Male patients with CSCR had a significantly higher CHD rate than those without CSCR, indicating that CSCR may be a potential risk factor for the development of CHD for men.

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Section: Discussionmentioning

confidence: 61%

Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study

Chen

Lian

2013

Br J Ophthalmol

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“…These studies suggested that CSCR could be an ocular finding of undefined systemic disease. In fact, it was reported that risk for stroke and coronary artery disease is higher in patients with CSCR compared to the general population in previously performed studies [33,34]. The author proposed that the choroidal vasculopathy observed in CSCR may not be isolated but rather part of a more diffuse deterioration in vascular function that is yet to be better characterized.…”

Section: Discussionmentioning

confidence: 87%

Evaluation of nailfold videocapillaroscopy in central serous chorioretinopathy

Erol

Balkarlı

Toslak

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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“…As compared to control patients, males with CSCR have a significantly higher rate of coronary heart disease (Hazard Ratio (HR): 1.72), indicating that CSCR may be a potential risk factor for the development of coronary heart disease in men . CSCR was also shown to be an independent risk factor for ischemic stroke (HR: 1.56; 95% confidence interval (CI), 1.11e2.18) (Tsai et al, 2012), and for organic and psychogenic erectile dysfunction (HR: 2.14; 95% CI, 1.34e3.44 and 3.83; 95% CI, 1.47e10.01, respectively) (Tsai et al, 2013b). Consequently, the choroidal vasculopathy described in CSCR may not be isolated but rather part of a more diffuse vascular dysfunction that is yet to be better characterized.…”

Section: Cardiovascular Diseases and Hypertensionmentioning

confidence: 97%

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis

Daruich

Matet

Dirani

et al. 2015

Progress in Retinal and Eye Research

819

996

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Central serous chorioretinopathy (CSCR) is a major cause of vision threat among middle-aged male individuals. Multimodal imaging led to the description of a wide range of CSCR manifestations, and highlighted the contribution of the choroid and pigment epithelium in CSCR pathogenesis. However, the exact molecular mechanisms of CSCR have remained uncertain. The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options. It also gives an overview of the novel mineralocorticoid pathway hypothesis, from animal data to clinical evidences of the biological efficacy of oral mineralocorticoid antagonists in acute and chronic CSCR patients. In rodents, activation of the mineralocorticoid pathway in ocular cells either by intravitreous injection of its specific ligand, aldosterone, or by over-expression of the receptor specifically in the vascular endothelium, induced ocular phenotypes carrying many features of acute CSCR. Molecular mechanisms include expression of the calcium-dependent potassium channel (KCa2.3) in the endothelium of choroidal vessels, inducing subsequent vasodilation. Inappropriate or over-activation of the mineralocorticoid receptor in ocular cells and other tissues (such as brain, vessels) could link CSCR with the known co-morbidities observed in CSCR patients, including hypertension, coronary disease and psychological stress.

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Central serous chorioretinopathy and risk of ischaemic stroke: a population-based cohort study

Abstract: CSCR is an independent indicator for the increased risk of subsequent ischaemic stroke development.

Cited by 38 publications

References 35 publications

Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study

Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study

Evaluation of nailfold videocapillaroscopy in central serous chorioretinopathy

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis

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