Central Serous Chorioretinopathy a Risk Factor for AMD

Final Stage Of Senile Macular Degeneration: Macular Atrophy. Photograph Of The Back Of Eye. (Photo By BSIP/UIG Via Getty Images)
Patients who develop CSC at an older age are particularly susceptible to developing the macular condition, according to a report.

Individuals with central serous chorioretinopathy (CSC) appear to be at increased risk of exudative age-related macular degeneration (AMD), according to a study published in Retina

Investigators conducted a population-based cohort study to estimate the risk of incident age-related macular degeneration in patients with CSC. They included 30,033 patients (age range: 30-80 years, 77.9% men, 22.1% women) diagnosed with CSC who received optical coherence tomography analysis within 1 month of diagnosis. Primary outcome measures were CSC incidence and risk of exudative AMD in individuals with CSC compared with those without CSC.

Investigators found that the 5 year cumulative CSC incidence was 92.35 (95% CI: 92.29-92.40) per 100,000 people. With respect to sex, CSC incidence was 144.94 (95% CI: 144.79-145.08) and 40.50 (95% CI: 40.43–40.58) per 100,000 among men and women, respectively. Mean age at diagnosis was 48±9 years in men compared with 51±10 years in women.

Researchers evaluated risk in a cohort of 11,492 individuals with CSC and 22,984 individuals without CSC. Among those participants, investigators noted exudative AMD in 166 (1.44%) individuals in the CSC group and 73 (0.32%) individuals in the non-CSC group. Multivariable Cox regression analysis revealed that the risk of exudative AMD was 4.86 (adjusted hazard ratio [HR], 95% CI, 2.98–5.88) times higher in the CSC group than in the non-CSC group (P <.001). A subgroup analysis revealed the risk was significantly higher in individuals aged 60 to 69 (HR, 2.78; 95% CI, 1.84–4.19) and 70 to 79 years (HR, 4.06; 95% CI, 2.22–7.45) compared with those aged 50 to 59 years (P < .001 for both).

“Although CSC is a self-limiting disorder, the incidence of exudative AMD increases with age after 60 years; thus, more frequent screening exams and self-screening using the Amsler grid are recommended,” according to the investigators.

Limitations of the study include possible mismatches between clinical manifestations and diagnostic codes, an inability to determine the subtypes of exudative AMD, laterality of the eyes affected with CSC, or exudative age-related macular degeneration, and the inability to adjust for individual risk factors and obtain information regarding ethnicity.

Reference

Lee JY, Bae K. Risk of exudative age-related macular degeneration in patients with central serous chorioretinopathy: a nationwide cohort study. Published online January 20, 2022. Retina. doi:10.1097/IAE.0000000000003412