Associations Between Topical Ophthalmic Corticosteroids and Central Serous Chorioretinopathy: A Taiwanese Population-Based Study

PURPOSE. To investigate the association between central serous chorioretinopathy (CSCR) and topical ophthalmic corticosteroid use. METHODS. Data were collected from the Longitudinal Health Insurance Database 2000, containing randomly selected medical claim data from 23 million residents in Taiwan. The study cohort comprised all patients diagnosed with CSCR between January 2001 and December 2010 (n = 2921) with a control group of patients (n = 17,526) matched to study patients according to age, sex, geographic region, and date of index medical care. Demographic characteristics, comorbidities, and corticosteroid use (topical ophthalmic, oral, nasal spray, injected, and inhaled) within 1 year before CSCR diagnosis were examined using univariate logistic regression. Student's t-test was used for continuous variables. Adjusted logistic regression was used to compare the odds ratio (OR) of the prognosis of CSCR patients with that of controls. RESULTS. In CSCR patients, we observed an increased prevalence of topical ophthalmic corticosteroid use (OR 6.328, 95% confidence interval [CI] 5.786-6.921, P < 0.0001). After adjusting for age, sex, geographic location of the patient's residence, hypertension, diabetes mellitus, hyperlipidemia, chronic renal disease, peptic ulcer, psychiatric disease, allergic respiratory disease, coronary artery disease, and corticosteroid use, conditional logistic regression analysis showed that CSCR patients were more likely to have used topical ophthalmic corticosteroids recently than the controls (OR 6.036, 95% CI 5.512-6.610, P < 0.0001). CONCLUSIONS. Results strongly support an association between recent topical ophthalmic corticosteroid use and CSCR. Thus, patients who require ophthalmic corticosteroids should be advised of the associated risk of developing CSCR.