title: Increased risk of erectile dysfunction among males with central serous chorioretinopathy -- a retrospective cohort study.
abstract: OBJECTIVE
  Central serous chorioretinopathy (CSCR) mostly affects middle-aged men and has been associated with stress and hypercortisolism. We hypothesized that some factors prone to inducing CSCR could also have a harmful effect on erectile function. This study aimed to investigate the risk of subsequent erectile dysfunction after CSCR using Taiwan National Health Insurance Research Database.
  
  
  METHODS
  The study cohort (n = 1220) consisted of newly diagnosed CSCR men aged 19-64 years between 1999 and 2007, and men matched for age, monthly income and time of enrolment were randomly selected as the control group (n = 10870). Cox proportional hazard regressions were performed to calculate the hazard ratios (HR) of clinically diagnosed erectile dysfunction (including organic origin and/or psychogenic origin) for the two groups. Erectile dysfunction-free survival analysis was assessed using a Kaplan-Meier method.
  
  
  RESULTS
  Twenty-five patients (2.0%) from the CSCR cohort and 103 (0.9%) from the control group were diagnosed erectile dysfunction clinically during a mean observation period of 4.3 years. Patients with CSCR had a significantly higher incidence of erectile dysfunction diagnosis than those without CSCR (p < 0.001). After adjusting for age, geographic location, chronic comorbidities and medication habits, patients with CSCR were found to have a 2.22-fold [95% confidence interval (CI), 1.42-3.46] higher hazard ratio of a subsequent erectile dysfunction diagnosis than the matched controls. The adjusted HR for organic and psychogenic erectile dysfunction were 2.14 (95% CI: 1.34-3.44) and 3.83 (95% CI: 1.47-10.01), respectively.
  
  
  CONCLUSIONS
  Central serous chorioretinopathy was independently associated with an increased risk of being diagnosed with erectile dysfunction.
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, TaiwanDepartment of Ophthalmology, National Yang-Ming University Hospital, Taipei, TaiwanInstitute of Pharmacology, National Yang-Ming University, Taipei, TaiwanCardiovascular Research Center, School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Medical Research and Education, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Biomedical Sciences, Academia Sinica, Taipei, TaiwanHealthcare and Management Center, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Der-Chong
authors.initials: DC
authors.lastname: Tsai
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: Chia-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
mesh_terms: D000328:Adult; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult