Dysfunctional Autonomic Regulation of the Choroid in Central Serous Chorioretinopathy

Roybal, C. Nathaniel; Sledz, Elisabeth; Elshatory, Yasser; Zhang, Li; Almeida, David R.P.; Chin, Eric K.; Critser, Brice; Abràmoff, Michael D.; Russell, Stephen R.

doi:10.1097/iae.0000000000001677

Cited by 19 publications

(12 citation statements)

References 15 publications

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“…The researchers found that, rather than Sattler's layer, Haller's layer leads to increased CT in patients with ICSCR, a finding that supports the view that focal occlusion at the level of the choriocapillaris, which is considered to be the primary cause of ICSCR, may not lead to increased CT (27). A recent study reported that the choriocapillaris and CT values of patients with ICSCR are significantly thicker than those of healthy controls in response to increased perfusion pressure in patients with ICSCR connected to transitioning from an upright to a supine position (28). The researchers suggested that the autoregulatory response is presumably better in the choriocapillaris layer than in the Haller's and Sattler's layers that consist of larger blood vessels (28).…”

Section: Discussionsupporting

confidence: 55%

“…A recent study reported that the choriocapillaris and CT values of patients with ICSCR are significantly thicker than those of healthy controls in response to increased perfusion pressure in patients with ICSCR connected to transitioning from an upright to a supine position (28). The researchers suggested that the autoregulatory response is presumably better in the choriocapillaris layer than in the Haller's and Sattler's layers that consist of larger blood vessels (28).…”

Section: Discussionmentioning

confidence: 99%

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The evaluation of the effect of Helicobacter pylori infection on choroidal thickness

Atılgan

Yozgat

Kösekahya

et al. 2018

Turk J Gastroenterol

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Background/Aims: To evaluate the effects of Helicobacter pylori infection on choroidal thickness (CT) using enhanced depth imaging spectral domain-optical coherence tomography (SD-OCT). Materials and Methods: A total of 63 right eyes of 63 patients who tested positive for H. pylori (Group 1) and 46 right eyes of 46 patients who tested negative for H. pylori (Group 2) were evaluated. The CTs at the subfoveal area and at 1 mm ranging up to 3 mm from the fovea at the nasal and temporal quadrants were measured and compared. After the eradication of H. pylori, the CT values were also compared with the pre-eradication values in 38 patients. Results: The mean age of patients was 43.6±9.5 years in Group 1 and 46.6±11.5 years in Group 2 (p=0.13). Differences in CT values between Groups 1 and 2 before and after H. pylori eradication were not statistically significant (p>0.05 for all values). Conclusion: The CT values of H. pylori positive and H. pylori negative patients were similar. Eradication of H. pylori infection appears to have produced no change in short-term CT.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

The evaluation of the effect of Helicobacter pylori infection on choroidal thickness

Atılgan

Yozgat

Kösekahya

et al. 2018

Turk J Gastroenterol

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“…In CSC this regulation may be failing, suggesting dysregulation of choroidal vascular mechanisms of control. 29 By contrast, retinal vessels lack of extrinsic autonomic control. Similarly to the brain where neuronal processes are associated with intraparenchymal vessels and regulate blood flow, autonomic receptors are intrinsic on retinal vessel walls.…”

Section: Discussionmentioning

confidence: 99%

Functionality of retinal vessels in central serous retinopathy: A comparison between eplerenone and photodynamic therapy

Tombolini

Battista

Sacconi

et al. 2022

European Journal of Ophthalmology

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Purpose To investigate retinal vessels functionality in patients with acute central serous chorioretinopathy (CSC) undergoing oral eplerenone or photodynamic therapy (PDT) using Retinal Vessel Analyzer (RVA) and Dynamic Vessel Analyzer (DVA), respectively. Methods Treatment naïve acute CSC patients presenting between May 2017 and June 2017 were recruited. A complete ophthalmological examination was performed in all participants before and after oral eplerenone (eplerenone group) or half-dose PDT (PDT group). Results Eighteen eyes of 18 patients affected by acute CSC underwent either oral eplerenone (10 eyes of 10 patients, 47.6 ± 8.9 years old) or half-dose PDT (8 eyes of 8 patients, 57.4 ± 6.2 years old), respectively. After 2 months of treatment, non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were reported in eplerenone group. Similarly, in PDT group non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were found after 2 months of treatment. Conclusions Static and dynamic retinal functionalities in acute CSC may not be significantly improved by oral eplerenone and half-dose PDT. Although their choroidal effects, these treatments could not exert a significant effect on retinal vessels motility. Thus, both local and systemic therapies might not help avoiding the onset of vascular and other retinal known alterations of CSC.

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“…[ 2 ] In others, the etiology appears to be choroidal dysfunction, particularly involving choroidal circulation which is under autonomic control. [ 3 4 5 6 7 8 ] Autonomic dysfunction such as heart rate variability and sympathetic-parasympathetic imbalance have been reported in CSC. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 4 5 6 7 8 ] Autonomic dysfunction such as heart rate variability and sympathetic-parasympathetic imbalance have been reported in CSC. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

The associations between central serous chorioretinopathy and muscle relaxants: A case–control study

Jain¹,

Garg²,

Chaudhary³

et al. 2022

Taiwan J Ophthalmol

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PURPOSE: To evaluate the role of muscle-relaxants as risk factors for the development of central serous chorioretinopathy (CSC) - the second most common retinopathy in our settings; despite multiple risk factors seen in our patients, 21% were initially labelled as idiopathic. MATERIALS AND METHODS: Retrospective case-control study at a tertiary hospital in the United Arab Emirates, where we reviewed the medical records of 273 patients with CSC examined between 2010 and 2019 for use of muscle-relaxants including tolperisone/eperisone, carisoprodol and gabapentin/pregabalin within a year of onset/recurrence of the disease. Intake of drugs with known association with CSC (including corticosteroids/sympathomimetics) was also recorded. Two hundred eighty-six subjects with adverse events seen at the same institute during the same study period served as controls. Odds ratios, Chi-Square tests and multivariate logistic regression were carried out to determine any associations with the muscle-relaxants and other pharmacological confounders - corticosteroids/sympathomimetics. RESULTS: Muscle relaxants may increase the risk of CSC as evident on multivariate regression analysis (OR: 2.55; confidence interval [CI]: 1.208-5.413); the significance was retained on removing the 6 subjects who had corticosteroids/sympathomimetics (OR: 2.30; CI: 1.073–4.939). Univariate analysis yielded an OR of 2.52 for muscle relaxants (CI: 1.2149–5.2276), 2.96 for eperisone/tolperisone (CI: 1.3531–6.5038), and 6.26 for eperisone as an individual agent (CI: 1.8146–21.6252). CONCLUSION: We found muscle relaxants to be associated factors of CSC regardless of inclusion of corticosteroids/sympathomimetics ( P < 0.05). Among individual classes of muscle relaxants in this study, only eperisone/tolperisone posed a significant risk ( P < 0.05). The vascular smooth muscle relaxation could be the possible mechanism that affects the choroidal blood flow and indirectly predisposes to CSC.

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Dysfunctional Autonomic Regulation of the Choroid in Central Serous Chorioretinopathy

Abstract: We demonstrated that choroidal thickness increased in response to increased perfusion pressures in patients with CSC and not in normal controls. These findings likely represent an autonomic dysregulation of choroidal blood flow in patients with CSC.

Cited by 19 publications

References 15 publications

The evaluation of the effect of Helicobacter pylori infection on choroidal thickness

The evaluation of the effect of Helicobacter pylori infection on choroidal thickness

Functionality of retinal vessels in central serous retinopathy: A comparison between eplerenone and photodynamic therapy

The associations between central serous chorioretinopathy and muscle relaxants: A case–control study

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