Risk factors for incident central serous retinopathy: case–control analysis of a US national managed care population

Aim To evaluate clinical comorbidities and steroid use as risk factors for central serous retinopathy (CSR). Methods Using national insurance databases, we conducted a case–control study of beneficiaries with an incident diagnosis of CSR between 2007 and 2015 (n=35 492) and randomly selected controls matched on age-based and sex-based propensity scores (n=1 77 460). Results The mean age (SD) of cases was 49.1 (12.2) years, and the majority (69.2%) were male. Cases were more likely to have received steroids in the past year (OR 1.14, 95% CI 1.09 to 1.19, p Helicobacter pylori infection and gastro-oesophageal reflux disease) had lower odds of CSR. Conclusions Male middle-aged patients with recent steroid exposure were significantly more likely to develop CSR. Other risk factors include diabetes mellitus, diabetic macular oedema and age-related macular degeneration. Other previously hypothesised risk factors did not appear to confer increased risk. More research is needed to confirm and examine underlying pathophysiology.