Helicobacter pylori as a potential target for the treatment of central serous chorioretinopathy

Abstract

OBJECTIVES:The objective of this study was to evaluate the relationship between the treatment of Helicobacter pylori gastric infection and changes in best-corrected visual acuity and macular detachment in patients with chronic central serous chorioretinopathy.METHODS:Seventeen patients diagnosed with central serous chorioretinopathy were examined for gastric infection with Helicobacter pylori using the urease test and gastric biopsy. Helicobacter pylori-positive patients were treated with the appropriate medication. The response to therapy was monitored by evaluating the best-corrected visual acuity and optical coherence tomography. The data were analyzed using Student's t-test before and after treatment.RESULTS:Fourteen patients (15 eyes) aged 30-56 years (mean 43.4±8.3 years) were positive for Helicobacter pylori. Most of the positive patients had gastric symptoms (78.5%); one had bilateral central serous chorioretinopathy. The mean baseline best-corrected visual acuity was 20/98 (logMAR = 0.53±0.28). Three months after starting treatment with antibiotics, the serous detachment had resolved in 14 of 15 eyes, but two cases required laser treatment. The follow-up period ranged from 6 to 27 months. The mean final best-corrected visual acuity differed significantly from baseline.CONCLUSION:Our findings suggest that Helicobacter pylori infection may be present in many chronic central serous chorioretinopathy patients and that treatment for the infection may have a favorable effect on the outcome of chronic central serous chorioretinopathy. Due to the possibility of the spontaneous regression of chronic central serous chorioretinopathy and the high prevalence of the infection in the general population, prospective and masked clinical trials are necessary to confirm that treatment for Helicobacter pylori infection may benefit patients with chronic central serous chorioretinopathy.

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis

“…Several studies also reported a high prevalence of Helicobacter pylori infection in CSCR patients (Ahnoux-Zabsonre et al, 2004;Cotticelli et al, 2006;Giusti, 2001;Mateo-Montoya and MaugetFaÿse, 2014;Mauget-Faÿsse et al, 2002;Roshani et al, 2014). H. pylori-dependent immune mechanism and molecular mimicry between pathogenic antigens and host proteins (Giusti, 2004) has been hypothesized but additional studies are needed to confirm the relationship between CSCR and H. pylori, and the benefit of H. pylori treatment on the course of CSCR, as suggested by some studies (Casella et al, 2012;Dang et al, 2013;Rahbani-Nobar et al, 2011).…”

Central Serous Chorioretinopathy

“…People referred to as having a type A personality are usually characterized by a highly status-conscious, ambitious and rigidly organized pattern of behavior [57]. Further risk factors that have been proposed include pregnancy, alcohol consumption, untreated hypertension, use of antibiotics, bone marrow or organ transplantation, infection of the respiratory tract and infection with Helicobacter pylori [12,44,58,59,60,61,62,63]. …”

Increased Incidence of Peptic Ulcer Disease in Central Serous Chorioretinopathy Patients

“…Peptic ulcer was highly correlated with CSR in our study. [16][17][18][19][20] Recent studies have shown that H. pylori infection may be a systemic disease, in addition to peptic ulcer disease, associated with gastric cancer, MALT lymphoma, 21,22 and abnormal gastroesophageal reflux. Abnormal gastroesophageal reflex, such as peptic ulcer disease, which is also one of the complications of Helicobacter pylori infection, has been noted to be associated with CSR.…”