title: Is myopia a protective factor against central serous chorioretinopathy?
abstract: OBJECTIVE
  To evaluate if any association exists between central serous chorioretinopathy (CSCR) and the refractive status of the eye.
  
  
  METHODS
  This retrospective, institutional, case control study included 499 patients, wherein 262 patients diagnosed as acute CSCR, were compared with an age and gender matched control group of 237 patients. All patients were evaluated with a detailed systemic and ocular history, objective and subjective refractions for both eyes and complete ocular examination by a retina specialist, at all visits. Optical coherence tomography confirmed the diagnosis of CSCR.
  
  
  RESULTS
  The mean age was found to be 40±7y in the study group (Group 1) compared to 38±10y in the control group (Group 2). Most common refractive status in the study group, was emmetropia seen in 191 patients (72.9%), followed by hypermetropia seen in 47 patients (17.9%) and astigmatism seen in 21 patients (8.0%). Only 3 subjects (1.1%) had myopia, which was less than or equal to 1.0 D, compared to 70 subjects (29.5%) in the control group, suggesting a statistically significant lower incidence of CSCR among the myopic patients (P< 0.0001). With respect to the systemic factors, 26 (9.9%) patients were using systemic steroids in the study group (Group 1) compared to none in the control group (Group 2) suggesting a statistically significant association of CSCR with systemic steroid use (P<0.05). No other significant systemic risk factors were noted.
  
  
  CONCLUSIONS
  Though CSCR is a multifactorial disease, myopia serves as a protective factor for CSCR. Thus, myopic eyes are less likely to develop CSCR. Since both retinal pigment epithelium (RPE) and choriocapillaris are postulated in the pathogenesis of CSCR, chorio-retinal thinning and atrophy seen in myopic eyes are less likely to cause CSCR.
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: George J
authors.initials: GJ
authors.lastname: Manayath
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: Hardik
authors.initials: H
authors.lastname: Parikh
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: Parag K
authors.initials: PK
authors.lastname: Shah
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: Sarvesh
authors.initials: S
authors.lastname: Tiwari
authors.affiliation: Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore 641 014, Tamil Nadu, India.
authors.forename: Venkatapathy
authors.initials: V
authors.lastname: Narendran
keywords: central serous chorioretinopathy; myopia; refractive status