Abstract
A smoking habit can cause various health problems encompassing retinal diseases including central serous chorioretinopathy (CSC). The aim of the current study was to investigate the effect of smoking on the choroidal structure in patients with CSC. The choroidal vascular index (CVI) was calculated using the binarized OCT images. Baseline parameters (age, refractive error [SE], subfoveal choroidal thickness [SFCT] and CVI) were compared between smokers and non-smokers using Wilcoxon rank sum test. Moreover, the associations between SFCT and the baseline parameters were analyzed using a multivariate linear regression followed by the AICc model selection. Among 75 CSC patients, 45 patients were smokers and 30 patients were non-smokers. No significant differences in age and SE were seen between the smoking group and the non-smoking group. A significant difference in the SFCT was seen between two groups (382.0 ± 68.2 μm in the smoking group vs. 339.3 ± 52.3 μm in the non-smoking group, p = 0.0038), while no significant difference was observed in the CVI (p = 0.32). The optimal model for SFCT included the variables of age, SE and past history of smoking among the baseline parameters. Additionally, increased pack years was associated with increased SFCT. Cigarette smoking was associated with an increased SFCT in patients with CSC. Thicker choroid in smoking CSC patients may be an important modulator of the disease.
Highlights
Central serous chorioretinopathy (CSC) is characterized by serous retinal detachment accompanied by the dysfunction of the retinal pigment epithelium (RPE)
A significant difference in the subfoveal choroidal thickness (SFCT) was seen between two groups (382.0 ± 68.2 μm in the smoking group vs. 339.3 ± 52.3 μm in the non-smoking group, p = 0.0038), while no significant difference was observed in the choroidal vascular index (CVI) (p = 0.32)
Cigarette smoking was associated with an increased SFCT in patients with CSC
Summary
Central serous chorioretinopathy (CSC) is characterized by serous retinal detachment accompanied by the dysfunction of the retinal pigment epithelium (RPE). Recent studies have clarified the change in the choroid. CSC is generally characterized by choroidal vascular hyperpermeability (CVH) on indocyanine green angiography [1,2,3]. Enhanced depth imaging (EDI-OCT) [4], which allows for the visualization of the choroidal structure, clarified the ratio of the luminal area to the total choroidal area, known as the choroidal vascular index (CVI) to be increased in CSC. Increased osmotic pressure, presumably due to an increased area of the choroidal vessels, is thought to be associated with choroidal hyperpermeability, causing RPE detachment, leading to the accumulation of fluid in the subretinal space. Eyes with acute CSC had a higher CVI than eyes without CSC or eyes with resolved CSC [7], suggesting that CVI is dynamically associated with CSC, which may change during the course of disease depending on the activity
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