Obstructive sleep apnea increases risk of CSC

Using a national sample of U.S. patients, this study is the first to estimate the effect of obstructive sleep apnea (OSA) on the absolute risk of central serous chorioretinopathy (CSC), stratified by age and sex.

Study design

In this retrospective cohort study, researchers used the IBM MarketScan database to select 59 million commercially insured patients in the United States between 2007 and 2016. Patients were identified by their first diagnosis of CSC and categorized as having OSA following a sleep study. Cox proportional hazard models were used to determine risk of developing CSC.

Outcomes

Risk of CSC increased with age and OSA diagnosis. The annual incidence of CSC was lower in women than men (9.6 vs. 23.4 per 100,000 individuals, respectively) but increased with OSA in both groups (17.2 and 40.8 per 100,000, respectively). The positive predictive value of CSC as a predictor of OSA was highest in the fifth decade of life.

Limitations

Limitations include coding errors and lack of granular clinical data, which are common among studies based on administrative claims data. The database also lacked other information such as BMI. In addition, the study does not encompass certain patient populations, such as those who are uninsured or on Medicaid.

Clinical significance

The incidence of CSC in this patient sample is higher than previously reported. In particular, older men who present with new-onset CSC may have undiagnosed OSA and may be reasonably referred for OSA evaluation.