Association between Central Serous Chorioretinopathy and Risk of Depression: A Population-Based Cohort Study.

Yu-Yen Chen,Pesus Chou,Li-Ying Huang,Wei-Ling Liao

doi:10.1155/2019/2749296

Abstract

Purpose To investigate the association between central serous chorioretinopathy (CSC) and the risk of developing depression. The risk factors associated with depression in CSC patients were also assessed. Methods A population-based retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from the beginning of 2001 through the end of 2013. CSC patients and age- and gender-matched (1 : 4 matched) control subjects without CSC were enrolled in the study. Kaplan–Meier curves were generated to compare the cumulative hazard of subsequent depression between the CSC and control groups. A Cox regression analysis estimated the crude and adjusted hazard ratios (HRs) for depression. Risk factors leading to depression were investigated among the CSC patients. Results 25,939 CSC patients and 103,756 controls were enrolled in the study. The CSC group had a significantly higher cumulative hazard for depression compared to the control group (p value < 0.0001). The Cox regression model indicated that the CSC group had a significantly higher risk for depression (adjusted HR = 1.33). Within the CSC group, significant risk factors for depression included age, female gender, low income, first-onset CSC, peptic ulcer, and smoking. The recent use of steroids prior to CSC, by all routes of administration, also significantly increased the risk for depression. However, treatment of CSC did not significantly reduce the risk for depression. Conclusion Patients with CSC are at significantly greater risk of developing depression. Among CSC patients, age, female gender, low income, first-onset CSC, peptic ulcer, smoking, and recent use of steroids prior to CSC were significant risk factors for depression.

Highlights

Central serous chorioretinopathy (CSC) is characterized by serous neurosensory retinal detachment of the macula with circulatory disturbances of the choroidal vasculature [1]. e symptoms of CSC include micropsia, metamorphopsia, reduced color sensitivity, and acute/subacute central vision loss or distortion [2]
We focused on the CSC patients and applied Cox regression to investigate the risk factors associated with depression among the CSC patients. e variables included in the analysis were age, gender, Charlson comorbidity index (CCI), insurance cost, urbanization level of residency, hypertension, peptic ulcer, smoking, recurrence of CSC, and types of steroid medication
Recent use of any type of steroid prior to the diagnosis of CSC significantly increased the risk of depression among CSC patients

Summary

Introduction

Central serous chorioretinopathy (CSC) is characterized by serous neurosensory retinal detachment of the macula with circulatory disturbances of the choroidal vasculature [1]. e symptoms of CSC include micropsia, metamorphopsia, reduced color sensitivity, and acute/subacute central vision loss or distortion [2]. E symptoms of CSC include micropsia, metamorphopsia, reduced color sensitivity, and acute/subacute central vision loss or distortion [2]. The etiologies of CSC remain unclear, many precipitating factors have been found, including stress, type A personality traits, and steroid use [1, 5,6,7]. E psychological stress and type A personality traits that are risk factors for CSC are risk factors for depression [8, 9]. CSC and depression have another common risk factor—steroid use [10]. Visual symptoms in CSC may increase the risk of depression. It is reasonable to speculate that there may be a relationship between CSC and depression

Methods

Results

Conclusion