Table 1 Risk factors for CSC.
From: Treatment of central serous chorioretinopathy: new options for an old disease
Category | Risk factors | Key considerations |
|---|---|---|
Corticosteroid use | Systemic corticosteroid use (oral, intravenous), local corticosteroid administration (inhaled, intranasal, epidural, intra-articular, topical, periocular) [19] | Steroid-induced CSC shows frequent bilaterality, atypical presentation and less male predilection than non-steroid-induced CSC [19] |
Endogenous hormonal changes | Endogenous hypercortisolism (Cushing syndrome, adrenal/pituitary tumours, ectopic adrenocorticotropic hormone-secreting tumours) [4]; pregnancy-related hormonal changes (elevated cortisol, progesterone, testosterone) [22], renin–angiotensin system activation, increased blood volume [4] | CSC is the leading cause of pregnancy-related acquired retinal/choroidal visual impairment [22] |
Autonomic dysfunction and sleep disorders | Sympathetic overactivation [23], decreased parasympathetic activity [98], obstructive sleep apnoea (5× increased risk) [23] | Association between CSC and autonomic imbalance [23]; sleep apnoea screening is recommended in patients with CSC [99] |
Infectious and drug-related factors | Helicobacter pylori infection, sympathomimetic agents (pseudoephedrine, oxymetazoline), MMDA [25], phosphodiesterase-5 inhibitors (sildenafil, tadalafil) [26] | Pathophysiological mechanisms of H. pylori in CSC remain unclear [24]; drug-induced CSC should be considered in at-risk patients [3, 36] |
Psychological and personality factors | Psychological stress, Type A personality [23], antipsychotic medication use, depression, adjustment disorder [28] | Recent studies using validated questionnaires found no clear association between CSC and maladaptive personality traits [29] |
Genetic risk factors | Single-nucleotide polymorphisms in CFH (rs3753394, rs1329428, rs800292) [30, 31], VIPR2 (rs3793217) [32], CDH5 [4], TNFRSF10A-LOC389641, GATA5 [33] | Genetic variations may influence choroidal circulation and steroid response, but functional impacts require further research [31] |
