Risk of Central Serous Chorioretinopathy in Male Androgen Abusers

Abstract

Introduction: Male gender is an important risk factor of central serous chorioretinopathy (CSC), and studies have explored the pathophysiological role of androgens in CSC with conflicting results. In this study, we shed light on this hot topic by exploring the risk of CSC in a large cohort of male androgen abusers. Methods: This study included male androgen abusers identified through a nationwide antidoping test program across Danish fitness centers from January 3 2006 to March 1 2018. For each case, we randomly sampled ten male controls using Danish nationwide registries. These controls were matched in age and date. Cases and controls were followed until May 16 2018. Data on diagnoses were extracted using the Danish National Registry of Patients using ICD-10 codes to identify cases with CSC. Results: We included 1189 cases and 11,890 controls. Mean age at the time of doping sentence was 27.4 ± 6.9 years, and mean length of follow-up was 15.8 ± 3.6 years. We identified no cases of CSC in androgen abusers, and five cases of CSC in the control cohort. The difference between groups was not statistically significant (P = 1.0). Conclusions: Male androgen abusers were not at increased risk of CSC. Considering the lack of any signal in this large study, we speculate that if male androgen plays any direct role in the pathophysiology of CSC, its role may be subtle at best.

Efficacy and Predictive Factors of Oral Spironolactone Treatment in Chronic Central Serous Chorioretinopathy

“…Tis was due to the strict exclusion of any patient with signs of CNV or PCV in our patient screening. Tis also led to a younger age of the included patients, especially female patients, which was associated with a greater incidence of CNV (38,39). In addition, another noteworthy point was the smaller male/female ratio (2.2/1) in our study population.…”

“…However, Subhi et al explored the risk of CSC in a large cohort of male androgen abusers in a recent study. These authors speculated that androgen plays a subtle role at best in the pathophysiology of CSC [ 39 ]. Thus, we speculated that the potentially different effects on males and females caused by the weak estrogen-like effects of spironolactone might be relatively weak and had little function in therapy.…”

Differential Expression of Sex-Steroid Receptors in the Choroid Aligns With Central Serous Chorioretinopathy Sex Prevalence Across Different Ages

“… 47 This sex-dependence to androgen exposure disappeared upon overexpression of AR in the female derived ECs. Therefore, even if CSC development is not directly related to androgen levels, 19 , 48 unresponsiveness to any circulating androgens in young women could potentially explain that CSC occurs more in young men.…”

Topical non‐steroidal anti‐inflammatory drugs for central serous chorioretinopathy: A systematic review and meta‐analysis

“…Central serous chorioretinopathy (CSC) is the fourth most common maculopathy and an exudative maculopathy that primarily presents in males aged 30–50 years (Kido et al, 2022; van Rijssen et al, 2019). Studies have identified endogenous or exogenous corticosteroids as important risk factors, but their exact aetiological role remains incompletely understood (Brinks, van Dijk, Kiełbasa, et al, 2022; Holtz et al, 2022; Subhi et al, 2023). Imaging studies find that venous outflow obstruction and arteriovenous anastomoses lead to a pachychoroid phenomenon of enlarged congested choroidal vessels (Brinks, van Dijk, Meijer, et al, 2022; Cheung et al, 2019; Spaide et al, 2022).…”