Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Department of Ophthalmology, Song-Shan Branch of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2021 Jun 1;84(6):655-663. doi: 10.1097/JCMA.0000000000000533.
Central serous chorioretinopathy (CSCR) and liver cirrhosis share numerous risk factors and may have possible connections. We aimed to investigate whether patients with liver cirrhosis and the severity of cirrhosis have an increased incidence of CSCR.
This population-based retrospective cohort study was conducted by collecting data from the Taiwan National Health Insurance Research Database from January 1, 2000, to December 31, 2015. We included patients who were newly diagnosed with cirrhosis and selected an equal number of sex- and age-matched control subjects. The effect of cirrhosis on the risk of CSCR was examined via a Cox proportional hazard regression analysis. The cumulative incidence of CSCR was assessed with the Kaplan-Meier method and the log-rank test.
Both groups in this study comprised a total of 25 925 individuals. The cirrhotic patients had a significantly higher cumulative risk of developing CSCR in following years than patients without cirrhosis (log-rank test < 0.001). Furthermore, compared with noncirrhotic patients, the risk of CSCR was increased 3.59-fold (95% confidence interval [CI], 2.31-5.28) in cirrhotic patients with complications, and 2.34-fold (95% CI, 1.27-3.24) in cirrhotic patients without complications. Additionally, male sex, springtime, diabetes mellitus, hepatitis B virus, and hepatitis C virus statistical significantly increased the incidence of CSCR.
Cirrhosis is an independent indicator of CSCR. Among the cirrhotic population, patients with ascites and other complications have a higher incidence of CSCR than those with uncomplicated cirrhosis. Physicians should be observant when managing cirrhotic patients with visual disturbances.
中心性浆液性脉络膜视网膜病变(CSCR)和肝硬化有许多共同的危险因素,两者之间可能存在关联。我们旨在探讨肝硬化患者及其肝硬化严重程度是否会增加 CSCR 的发病率。
本研究采用回顾性队列研究,数据来自 2000 年 1 月 1 日至 2015 年 12 月 31 日的台湾全民健康保险研究数据库。我们纳入了新诊断为肝硬化的患者,并选择了相同数量的性别和年龄匹配的对照组。通过 Cox 比例风险回归分析检查肝硬化对 CSCR 风险的影响。采用 Kaplan-Meier 方法和对数秩检验评估 CSCR 的累积发病率。
本研究两组共纳入 25925 人。与无肝硬化的患者相比,肝硬化患者在随后的几年中发生 CSCR 的累积风险显著更高(对数秩检验<0.001)。此外,与无肝硬化的患者相比,有并发症的肝硬化患者发生 CSCR 的风险增加了 3.59 倍(95%置信区间[CI],2.31-5.28),无并发症的肝硬化患者发生 CSCR 的风险增加了 2.34 倍(95%CI,1.27-3.24)。此外,男性、春季、糖尿病、乙型肝炎病毒和丙型肝炎病毒均显著增加了 CSCR 的发病率。
肝硬化是 CSCR 的独立预测指标。在肝硬化患者中,有腹水和其他并发症的患者比无并发症的肝硬化患者发生 CSCR 的风险更高。当管理出现视觉障碍的肝硬化患者时,医生应保持警惕。