Physiologic and Psychologic Risk Factors in Central Serous Chorioretinopathy

Mansour, Ahmad M.; Koaik, Mona; Lima, Luiz H.; Casella, Antônio Marcelo Barbante; Uwaydat, Sami H.; Shahin, Maha; Tamim, Hani; Sánchez‐Ruiz, María‐José; Mansour, Hana A.

doi:10.1016/j.oret.2017.02.009

Cited by 17 publications

(22 citation statements)

References 39 publications

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“…CSCR was primarily found in middle-aged men between 45 and 55 years of age [ 21 ]. In our study, the mean age of the 120 subjects was 45.5 ± 2.5 years, which is consistent with most other reports, and the majority were male (92; 76.7%), while there were only 28 females (23.3%) [ 22 ]. At the end of the third month, there were 104 “success” patients from across the two groups, with a total success rate of 86.6%.…”

Section: Resultssupporting

confidence: 92%

Oral Treatment of Central Serous Chorioretinopathy Patients Using Propranolol Tablets

Chen

Shieh

et al. 2020

Pharmaceuticals

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Purpose: To evaluate the pharmacological effects of propranolol treatment of patients with central serous chorioretinopathy (CSCR) over 4 months. Results: Among the 89 male and 31 female patients, the mean BCVA decreased to 0.42 ± 0.08 logMAR during CSCR attacks. Oral propranolol showed good effectiveness in reducing CSCR signs after at least 4 months of treatment. The final BCVA of the patients in groups 1 and 2 was 0.09 ± 0.01 and 0.19 ± 0.03 logMAR, respectively (p < 0.05). Moreover, the mean complete remission time in groups 1 and 2 was 1.9 and 3.5 months, respectively (p < 0.05), while the “success” rate in groups 1 and 2 was 95.0% (57/60) and 78.3% (47/60), respectively (p < 0.05). The recurrence rate in groups 1 and 2 was 5.3% (3/57) and 25.5% (12/47) after a further 5 months of follow-up, respectively (p < 0.05). Materials and Methods: One hundred and twenty patients were enrolled and randomly divided into two groups that both underwent a visual acuity test and optical coherence tomography (OCT) scanning, between April and December 2017. The 60 patients in group 1 were requested to take propranolol for 4 months, while the other 60 subjects (group 2) received placebo therapy during the same period. The best-corrected visual acuity (BCVA) of every volunteer and an OCT image of each patient were checked and recorded at the beginning of the study and each week thereafter. If the signs of CSCR disappeared completely from the OCT scans, the case was considered a “success” and treatment stopped at once. However, the “success” subjects were further evaluated in follow-ups throughout the next 5 months to determine the rate of recurrence in groups 1 and 2. The time of total complete remission of CSCR from the OCT scans was also measured in groups 1 and 2. Conclusion: CSCR patients revealed an excellent prognosis and success rate of 95.0% after taking propranolol. The treatment was able to enhance subretinal fluid (SRF) absorption, shorten the time to total complete remission, and significantly decrease CSCR recurrence. As such, we suggest that taking propranolol may be an alternative and viable choice for CSCR patients, given that the new method was shown to be safe, cheap, effective, well tolerated and convenient.

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Section: Resultssupporting

confidence: 92%

Oral Treatment of Central Serous Chorioretinopathy Patients Using Propranolol Tablets

Chen

Shieh

et al. 2020

Pharmaceuticals

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“…Four studies describe a higher prevalence of type-A personality in CSC patients [ 29 , 31 , 32 , 33 ], although wide differences between data emerged (96.8% of patients who recognized precipitating factor in Romano et al 2019 [ 29 ]; 26.19% in Islam et al 2017 [ 33 ]). Mansour et al (2017) [ 31 ], in addition to type-A personality, evaluated personality traits in CSC patients not affected by chronic, non-resolving disease. All patients were assessed using a psychodiagnostics battery composed of different tests in a short form.…”

Section: Resultsmentioning

confidence: 99%

Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020)

et al. 2021

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Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.

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“…CSCR usually presents as a well-circumscribed, serous detachment of the neurosensory retina from the retinal pigment epithelium (RPE) due to subretinal fluid (SRF) accumulation from a single or multiple leakage points [5,6]. CSCR risk factors include male gender, hypertension, type-A personality, stress, pregnancy, corticosteroids, psychopharmacologic medication, autoimmune disease, sleeping disturbance, and Helicobacter pylori infection [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Bilateral chronic central serous chorioretinopathy associated with IGRA latent tuberculosis infection: A case report and review

Kavanaugh¹,

Shaukat²,

Pan³

et al. 2020

New Front Ophthalmol

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A 37-year-old Indian male presented with a 3-year history of right eye blurred vision. Bilateral ophthalmic examinations revealed shallow, oval areas of macular subretinal fluid containing hypopion-like precipitates and central neurosensory retinal detachments with focal early-stage fluorescein leakage consistent with central serous chorioretinopathy (CSCR). Inadequate response to Eplerenone prompted reassessment yielding a positive BCG vaccine history. Latent tuberculosis infection (LTBI) was diagnosed by a positive interferon-γ response assay (IGRA) in the absence of pulmonary symptoms. Rifampin alone yielded only modest bilateral visual acuity increases and subretinal fluid decreases. Right eye focal macular laser was performed to stabilize vision with modest subretinal fluid decrease, but peripheral retinal lesions were noted on follow up. The patient has been unavailable for follow up evaluation and supportive anti-tuberculosis treatment (ATT) to date. The unresponsiveness to anti-corticosteroid medications in our case of CSCR secondary to LTBI, the reported detection of Mycobacterium tuberculosis DNA in CSCR subretinal fluid, and the resolution CSCR post ATT in 3 previous CSCR secondary to LTBI cases support a possible association of CSCR and LTBI. To our knowledge this is the fourth case of chronic CSCR in a patient with LTBI.

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Physiologic and Psychologic Risk Factors in Central Serous Chorioretinopathy

Cited by 17 publications

References 39 publications

Oral Treatment of Central Serous Chorioretinopathy Patients Using Propranolol Tablets

Oral Treatment of Central Serous Chorioretinopathy Patients Using Propranolol Tablets

Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020)

Bilateral chronic central serous chorioretinopathy associated with IGRA latent tuberculosis infection: A case report and review

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