Association of Corticosteroid Use With Incidence of Central Serous Chorioretinopathy in South Korea

Rim, Tyler Hyungtaek; Kim, Hee Suk; Kwak, Jay Jiyong; Lee, Jihei Sara; Kim, Dong Wook; Kim, Sung Soo

doi:10.1001/jamaophthalmol.2018.3293

Cited by 22 publications

(15 citation statements)

References 17 publications

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“…Recently, a population-based study in Korea reported an annual CSC incidence rate of 3.5 per 10,000 person-years (5.4 and 1.6 per 10,000 person-years in men and women, respectively). 13 In the present study, the incidence of CSC was 19.61 per 100,000 person-years (30.49 and 8.88 per 10,000 person-years in men and women, respectively). The lower incidence of CSC in our study may be the result of differences in the strict definition of CSC (i.e., use of optical coherence tomography examination for diagnosis) and exclusion criteria.…”

Section: Discussionsupporting

confidence: 45%

“…The annual incidence of CSC per 10,000 person-years is 2.1 in Taiwanese, 3.5 in Korean, and 1.0 in Caucasian populations. [12][13][14] Furthermore, polypoidal choroidal vasculopathy (or aneurysmal Type 1), a distinct subtype of exudative AMD, accounts for 20% to 55% of exudative AMD in Asian populations but only 8% to 13% in Caucasian populations. 15 Whether the subtype of exudative AMD is associated with the history of CSC is an important question, but at present, there is insufficient evidence to confirm this.…”

mentioning

confidence: 99%

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Risk of Exudative Age-Related Macular Degeneration in Patients With Central Serous Chorioretinopathy

Lee

Bae

2022

Retina

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Section: Discussionsupporting

confidence: 45%

mentioning

confidence: 99%

Risk of Exudative Age-Related Macular Degeneration in Patients With Central Serous Chorioretinopathy

Lee

Bae

2022

Retina

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“…These rare diseases were selected based on a previous review on OCT diagnosis [ 24 ]. According to the Orphan database, central serous chorioretinopathy [ 25 ], Stargardt disease [ 26 ], and retinitis pigmentosa [ 27 ] are considered as rare retinal diseases [ 28 ]. Because macular telangiectasia [ 29 ] and macular hole [ 30 ] also have very low prevalence, it is reasonable to consider them as relatively rare diseases.…”

Section: Methodsmentioning

confidence: 99%

Feasibility study to improve deep learning in OCT diagnosis of rare retinal diseases with few-shot classification

Yoo

Choi

Kim

2021

Med Biol Eng Comput

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Deep learning (DL) has been successfully applied to the diagnosis of ophthalmic diseases. However, rare diseases are commonly neglected due to insufficient data. Here, we demonstrate that few-shot learning (FSL) using a generative adversarial network (GAN) can improve the applicability of DL in the optical coherence tomography (OCT) diagnosis of rare diseases. Four major classes with a large number of datasets and five rare disease classes with a few-shot dataset are included in this study. Before training the classifier, we constructed GAN models to generate pathological OCT images of each rare disease from normal OCT images. The Inception-v3 architecture was trained using an augmented training dataset, and the final model was validated using an independent test dataset. The synthetic images helped in the extraction of the characteristic features of each rare disease. The proposed DL model demonstrated a significant improvement in the accuracy of the OCT diagnosis of rare retinal diseases and outperformed the traditional DL models, Siamese network, and prototypical network. By increasing the accuracy of diagnosing rare retinal diseases through FSL, clinicians can avoid neglecting rare diseases with DL assistance, thereby reducing diagnosis delay and patient burden.

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“…However, in contrast to the other GCs-induced side effects, the route of GCs administration influences the risk of CSCR. The nasal, articular, oral and dermal routes favor CSCR [12][13][14][15][16][17][18][19][20][21] but not the high and sustained intraocular GCs [22,23]. This clinical observation led us to hypothesize that it is not the increase in ocular GCs levels but rather a consequence of systemic corticosteroids on ocular corticosteroids that may be the link between CSCR and corticosteroid therapy.…”

Section: Introductionmentioning

confidence: 99%

Chronic Systemic Dexamethasone Regulates the Mineralocorticoid/Glucocorticoid Pathways Balance in Rat Ocular Tissues

Zola

Mejlachowicz

Arribada

et al. 2022

IJMS

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Central serous chorioretinopathy (CSCR) is a retinal disease affecting the retinal pigment epithelium (RPE) and the choroid. This is a recognized side-effect of glucocorticoids (GCs), administered through nasal, articular, oral and dermal routes. However, CSCR does not occur after intraocular GCs administration, suggesting that a hypothalamic-pituitary-adrenal axis (HPA) brake could play a role in the mechanistic link between CSCR and GS. The aim of this study was to explore this hypothesis. To induce HPA brake, Lewis rats received a systemic injection of dexamethasone daily for five days. Control rats received saline injections. Baseline levels of corticosterone were measured by Elisa at baseline and at 5 days in the serum and the ocular media and dexamethasone levels were measured at 5 days in the serum and ocular media. The expression of genes encoding glucocorticoid receptor (GR), mineralocorticoid receptors (MR), and the 11 beta hydroxysteroid dehydrogenase (HSD) enzymes 1 and 2 were quantified in the neural retina and in RPE/ choroid. The expression of MR target genes was quantified in the retina (Scnn1A (encoding ENac-α, Kir4.1 and Aqp4) and in the RPE/choroid (Shroom 2, Ngal, Mmp9 and Omg, Ptx3, Plaur and Fosl-1). Only 10% of the corticosterone serum concentration was measured in the ocular media. Corticosterone levels in the serum and in the ocular media dropped after 5 days of dexamethasone systemic treatment, reflecting HPA axis brake. Whilst both GR and MR were downregulated in the retina without MR/GR imbalance, in the RPE/choroid, both MR/GR and 11β-hsd2/11β-hsd1 ratio increased, indicating MR pathway activation. MR-target genes were upregulated in the RPE/ choroid but not in the retina. The psychological stress induced by the repeated injection of saline also induced HPA axis brake with a trend towards MR pathway activation in RPE/ choroid. HPA axis brake causes an imbalance of corticoid receptors expression in the RPE/choroid towards overactivation of MR pathway, which could favor the occurrence of CSCR.

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Association of Corticosteroid Use With Incidence of Central Serous Chorioretinopathy in South Korea

Cited by 22 publications

References 17 publications

Risk of Exudative Age-Related Macular Degeneration in Patients With Central Serous Chorioretinopathy

Risk of Exudative Age-Related Macular Degeneration in Patients With Central Serous Chorioretinopathy

Feasibility study to improve deep learning in OCT diagnosis of rare retinal diseases with few-shot classification

Chronic Systemic Dexamethasone Regulates the Mineralocorticoid/Glucocorticoid Pathways Balance in Rat Ocular Tissues

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