AUG 09, 2022
Using both multimodal imaging and genetic testing, researchers examined biological gender differences to better elucidate the pathogenesis of central serous chorioretinopathy (CSR).
This retrospective series compared clinical and genetic features of central serous chorioretinopathy (CSR) between males and females in 302 consecutive patients. The series consisted of 249 males and 53 females. Fluorescein angiography (FA), indocyanine green angiography (ICG), optical coherence tomography (OCT), and fundus autofluorescence (FAF) were completed for all patients. Genetic testing also was completed in all patients for the complement factor H (CFH) risk alleles.
At initial presentation, female patients diagnosed with CSR were significantly older (61.6 versus 55.1 years) and had thinner subfoveal choroidal thickness and increased central retinal thickness compared to male patients. A “descending tract” on FAF imaging was significantly more common in males (18.1% versus 0%) than in females. The risk allele frequency (CFH rs800292 and CFH rs1329428) were similar between genders.
The study is limited by the retrospective nature of the data. Only 53 patients (~17%) were female, which limited imaging and genetic data of the female cohort. The study was completed in Japan, potentially limiting generalizability to other racial and ethnic populations. Moreover, a distinction between acute and chronic CSR was not reported.
The association of CSR with male gender and hormone levels (testosterone, corticosteroids) are commonly known. However, the etiology of CSR remains incompletely understood. Studies such as this underscore the need for additional work to understand the underlying pathophysiology, clinical characteristics, and genetic predilections for this disease, and how the disease may differ in populations without conventional risk associations.