Shirian Jonathan D, Shaia Jacqueline K, Das Nikhil, Talcott Katherine E, Singh Rishi P, Mammo Danny A
Case Western Reserve University School of Medicine, Cleveland, Ohio; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Ophthalmol Retina. 2025 May;9(5):460-464. doi: 10.1016/j.oret.2024.10.026. Epub 2024 Nov 8.
The prevalence of central serous chorioretinopathy (CSCR) among transmasculine, polycystic ovary syndrome (PCOS), and androgen-exposed patients remains largely unexplored. Although these groups involve patients with elevated testosterone levels, previous literature is inconclusive on the influence of testosterone on CSCR. This study aimed to determine the relationship between CSCR and cohorts with exogenous androgen exposure, female-to-male (FTM) transgender individuals, and those diagnosed with PCOS.
Cross sectional study.
Patients with CSCR, receiving exogenous androgens, FTM transgender individuals (defined as gender identity disorder [GID], endocrine disorder not otherwise specified, sex-discordant hormone therapy, and FTM surgery), and patients with PCOS.
An electronic health records platform of >100 million patients was examined for this study. Patients were identified through 10th revision of the International Classification of Diseases and procedural codes. Patients with prior steroid prescriptions, anxiety disorders, and fluticasone use were excluded. Prevalence and prevalence odds ratios (ORs) of comorbid CSCR were calculated using RStudio and 95% confidence intervals (CIs) were calculated.
Prevalence, prevalence ORs, and 95% CIs of CSCR.
Among 21 056 patients with CSCR, the mean age was 61 years (standard deviation ± 15), with 67.95% being male. The prevalence of CSCR was highest among those receiving exogenous androgen therapy (24.13 per 1000 patients with CSCR; OR: 5.84, 95% CI: 5.35-6.37). The FTM surgery (OR: 3.04) and sex-discordant hormone therapy (OR: 5.32) cohorts also showed significant associations with CSCR (P < 0.05). Patients with PCOS had a more limited but still significant association (OR: 1.23, 95% CI: 1.013-1.49). Gender identity disorder did not show a significant relationship with CSCR (P > 0.05).
This study, which investigated the associations between FTM transgender, patients with PCOS, and CSCR demonstrates that conditions linked with elevated androgens are associated with higher odds of CSCR. These findings emphasize the value of ophthalmic screenings in these populations, particularly within the transgender health care community.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
在跨性别男性、多囊卵巢综合征（PCOS）患者以及雄激素暴露人群中，中心性浆液性脉络膜视网膜病变（CSCR）的患病率在很大程度上仍未得到充分研究。尽管这些人群中的患者睾酮水平升高，但既往文献对于睾酮对CSCR的影响尚无定论。本研究旨在确定CSCR与外源性雄激素暴露人群、女性向男性（FTM）跨性别者以及被诊断为PCOS的人群之间的关系。
横断面研究。
CSCR患者、接受外源性雄激素治疗者、FTM跨性别者（定义为性别认同障碍[GID]、未另作说明的内分泌疾病、性别不一致的激素治疗以及FTM手术）以及PCOS患者。
本研究对一个拥有超过1亿患者的电子健康记录平台进行了检查。通过国际疾病分类第10版和手术编码来识别患者。排除曾有类固醇处方、焦虑症以及使用氟替卡松的患者。使用RStudio计算合并CSCR的患病率和患病率比值比（OR），并计算95%置信区间（CI）。
CSCR的患病率、患病率OR以及95%CI。
在21056例CSCR患者中，平均年龄为61岁（标准差±15），其中67.95%为男性。接受外源性雄激素治疗的患者中CSCR患病率最高（每1000例CSCR患者中有24.13例；OR：5.84，95%CI：5.35 - 6.37）。FTM手术组（OR：3.04）和性别不一致的激素治疗组（OR：5.32）也显示出与CSCR有显著关联（P < 0.05）。PCOS患者的关联程度较为有限但仍具有统计学意义（OR：1.23，95%CI：1.013 - 1.49）。性别认同障碍与CSCR未显示出显著关系（P > 0.05）。
本研究调查了FTM跨性别者、PCOS患者与CSCR之间的关联，结果表明与雄激素升高相关的情况与CSCR的较高发病几率相关。这些发现强调了在这些人群中进行眼科筛查的价值，尤其是在跨性别医疗保健社区内。
在本文末尾的脚注和披露部分可能会找到专有或商业披露信息。
