New risk factors for retinal disorder identified

Antibiotics, antihistamines, alcohol use, tobacco use, untreated hypertension and multisystem autoimmune diseases are potential risk factors for a retinal disorder known as central serous chorioretinopathy. This is the conclusion of a study appearing in the February issue of Ophthalmology, the clinical journal of the American Academy of Ophthalmology, the Eye M.D. Association. Central serous chorioretinopathy, or CSCR, is a disorder in which retinal cells detach and atrophy, causing visual impairment and loss.

In this case-control study, the records of 312 patients with CSCR and 312 patients with other ophthalmic conditions were examined at Boston University School of Medicine’s Department of Ophthalmology Hospitals and Clinics, the Massachusetts Eye and Ear Infirmary, the Department of Ophthalmology at Indiana University School of Medicine, and the offices of Ophthalmic Consultants of Boston.

Similar to previous studies, this study found the strongest association of CSCR with systemic corticosteroid use and pregnancy. Sean Koh, MD, a vitreoretinal fellow in the Retina Service of the Massachusetts Eye and Ear Infirmary, Harvard Medical School, and a co-author of the study, said, “In addition, this study shows a wide variety of new systemic factors are associated with CSCR. These are: alcohol, antibiotic, antihistamine and tobacco use, and untreated hypertension and allergic respiratory disease. Patients should be checked for these conditions, and advised to manage hypertension with anti-hypertensive medication, to cease use of alcohol and tobacco, and to avoid unnecessary or excessive use of antibiotics and antihistamines.”

“Further,” Dr. Koh said, “psychological stress, which could not be assessed in this study because of the study design, may contribute to some of the associations identified. Whether modulating the risk factors identified in this study will affect the course or severity of CSCR requires further prospective investigation.”

Academy spokesperson Jose Pulido, MD, professor of ophthalmology and head of the Department of Ophthalmology at the University of Illinois, Chicago, said, “The main message from this study is that there are multiple underlying conditions that can result in CSCR. Therefore, it is important for Eye M.D.s to discuss the possible risk factors with the patient, and take steps to eradicate those risk factors, treat the disease and prevent recurrences.”

Dr. Pulido added, “This study also mentions the association between CSCR and antihistamine use may be in fact an association with other medications, such as decongestants. Of course, any changes in medications must be weighed against potential adverse effects.”

The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons–Eye M.D.s–with more than 27,000 members worldwide. For more information about eye health care, visit the Academy’s partner Web site, the Medem Network, at www.medem.com/eyemd. To find an Eye M.D. in your area, visit the Academy’s Web site at http://www.aao.org.